Gender bias and sex-based differences in health care efficiency in Polish regions

Błażej Łyszczarz

doi:10.1186/s12939-016-0501-y

Błażej Łyszczarz

Open Access

https://doi.org/10.1186/s12939-016-0501-y

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Abstract

BackgroundHealth differences between sexes are relatively well recognized, though less is known about the specificity of women's and men's health responsiveness to medical care. Applying data from Polish regions, this study identifies sex-based differences in medical care efficiency and investigates the reasons for these disparities in the gender bias context.MethodsThe study estimates sex-specific health production functions for regional data from Poland (1999–2013). Using panel-data regression, male and female life expectancies at ages 0, 15, 30, 45, 60 and 65 are regressed on a set of socioeconomic factors, with the primary interest in medical care proxied by doctor density.ResultsThe results show that in Poland the association between life expectancy and doctor density was positive for both men and women; however, the coefficients for medical care were insignificant for those at birth and at the age of 30 for both sexes. The magnitude of health care for longevity was higher for men comparing to women at every age, though the difference between sexes was not statistically significant. The sex-based disparities in medical care efficiency were more pronounced at younger ages and they diminished with age. The inspection of data on the health system in Poland shows that male patients seemed to be in an advantageous position: the mean reimbursement per service for men was higher in most medical care areas; men reported less problems with access to health care; and their mortality trend exhibited more favorable evolution over time. Additionally, the association between other socioeconomic factors and health also differed across sexes, and several of these factors were more important for life expectancy than health care.ConclusionPolish medical care suffers from gender bias, which possibly makes men more responsive to medical care. The disparities in the operation of medical care in Poland should be challenged to achieve more equal access to services between sexes and possibly to gain more health from the treatment of female patients.

Highlights

Health differences between sexes are relatively well recognized, though less is known about the specificity of women's and men's health responsiveness to medical care
The concept of health production can be specified in terms of the following functional relationship: H = f(X), where H is a measure of health status and is the output of the production process, and X is a vector of inputs including factors, such as health care utilization, income, education, health-related lifestyle, environmental factors and initial health status
This study investigated the associations between doctor density and life expectancy (LE) of men and women in Polish regions (1999–2013) controlling for several socioeconomic factors

Summary

Introduction

Health differences between sexes are relatively well recognized, though less is known about the specificity of women's and men's health responsiveness to medical care. There are several aggregate-level studies concerned with estimating the association between medical care and the health of women and men, so far they have failed to arrive at unambiguous conclusions about which sex is more responsive to medical care. It is unclear whether men benefit from health care more than women do, as argued by some authors [6,7,8,9], or whether the opposite is correct [10,11,12,13]. In the earlier studies, the data constraints prevented researchers from untangling complex sexspecific relationships and only allowed for speculations on potential reasons for these differences [6,7,8,9,10,11,12,13,14]

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