Abstract
Women have consistently lower mortality rates than men at all ages and with respect to most causes. However, gender differences regarding hospital admission rates are more mixed, varying across ages and causes. A number of intuitive metrics have previously been used to explore changes in hospital admissions over time, but have not explicitly quantified the gender gap or estimated the cumulative contribution from cause-specific admission rates. Using register data for the total Danish population between 1995 and 2014, we estimated the time to first hospital admission for Danish men and women aged 60. This is an intuitive population-level metric with the same interpretive and mathematical properties as period life expectancy. Using a decomposition approach, we were able to quantify the cumulative contributions from eight causes of hospital admission to the gender gap in time to first hospital admission. Between 1995 and 2014, time to first admission increased for both, men (7.6 to 9.4 years) and women (8.3 to 10.3 years). However, the magnitude of gender differences in time to first admission remained relatively stable within this time period (0.7 years in 1995, 0.9 years in 2014). After age 60, Danish men had consistently higher rates of admission for cardiovascular conditions and neoplasms, but lower rates of admission for injuries, musculoskeletal disorders, and sex-specific causes. Although admission rates for both genders have generally declined over the last decades, the same major causes of admission accounted for the gender gap. Persistent gender differences in causes of admission are, therefore, important to consider when planning the delivery of health care in times of population ageing.
Highlights
IntroductionWomen live longer than men in all countries of the world. The gender gap in life expectancy has persisted over time, but it has changed in magnitude, from increasing throughout the twentieth century to decreasing thereafter (Thorslund et al 2013)
On average, women live longer than men in all countries of the world
The gender gap in life expectancy has persisted over time, but it has changed in magnitude, from increasing throughout the twentieth century to decreasing thereafter (Thorslund et al 2013)
Summary
Women live longer than men in all countries of the world. The gender gap in life expectancy has persisted over time, but it has changed in magnitude, from increasing throughout the twentieth century to decreasing thereafter (Thorslund et al 2013). The contribution different causes of death have made to the narrowing gender gap in life expectancy are relatively well established. Attention has been drawn to the relatively faster declines in deaths from circulatory and smoking-related diseases among men throughout the end of the twentieth century (Sundberg et al 2018). Despite these improvements, the most recent estimates for countries within the European Union show that the gender gap in life expectancy is between 3.2 years and 9.9 year Gender differences in life expectancy have important implications for how healthcare responds to population ageing. Hospital admissions are a fundamental element of the healthcare system which may be vulnerable to
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