Distribution of missing women in outpatient clinics of a tertiary health care facility in India

Abstract

Introduction: There is a Paucity of Studies exploring Gender disparity in health care access factors affecting it in Developing countries. Aims and objectives: Analysis of gender disparity in access to healthcare and its relationship with the patient’s age and distance from the Hospital. Materials and Methods: A retrospective observational cross sectional study based on outpatient data from a Private Medical College in Ghaziabad. Cross tabulation were done for Sex and age class(young, middle, older) and Estimates from hierarchical logistic regression were used to compute sex ratios (male/female) of patient visits as a function of age and distance (in kilometers) from the hospital and age. Results: A total of 1 lakh 86 patients visited Santosh Hospital Outpatient clinics 2,11,183 times in departments of Medicine, Surgery, Pulmonary Medicine, Paediatrics, Psychiatry, Orthopaedics and Dermatology from July 2018 to July 2019. Out of these 1 lakh 86 patients – 51022 were Males and 49844 were females (Sex ratio of 1.02). Sex ratio had a parabolic (U curve) relationship with Age implying that Sex ratio worsened at extreme age. The Sex ratio in age groups 0-18,19-30,31-45,46-60 and >60 are 1.21,1.06,0.91,1.01 and 1.14 respectively. On adjusting for department in multivariable logistic regression, distance from hospital (available in 820 patients) was significantly associated with probability of a male outpatient visit. Odds Ratio (1.23, 95% CI 1.02-1.48, P value = 0.046). Conclusion: Gender disparity was observed in access to healthcare, which was worse at extremes of age (younger and older age groups) and at higher distance from Hospital. Keywords: Sex Ratio, Gender disparity, Health access, Primary health care, Demographic profile.