Abstract
This study intends to inspect the sex differences in proportion of hospital outpatient department (OPD) visits in overall outpatient (OP) visits using national panel data and to explore factors that influence the proportions by sex. This study analyzed data of the 2009–2016 Korea Health Panel Survey. Fractional logit regression was applied to analyze factors that affect proportion of hospital visits among outpatient visits. Analysis of related factors was carried out first for all analysis subjects and then by sex. The study data were provided by 7470 women (52.2%) and 6846 men (47.8%). The overall average number of OP visits was 13.0, and women showed a much higher frequency of visits (15.8) than men (9.9). The average proportion of hospital OPD visits among overall OP visits was 21.9%, and men showed a higher rate (25.1%) than women (19.5%). The analysis model including sociodemographic factors, economic factors, and health-related factors confirmed that men showed a higher rate of hospital usage than women. Type of medical security, household income, participation in economic activities, disability, and serious illnesses were significant variables for both sexes. Age, education level, marital status, and subscription to voluntary private health insurance were significant only for women, whereas region of residence was significant only for men. This study confirmed that there is a sex difference in proportion of hospital OPD visits and in the factors that affect the proportion of hospital OPD visits. Universal health coverage is provided through social health insurance, but there is a sex difference in hospital OPD visits, and factors related to socioeconomic status have a significant effect, especially on women’s selection of health care institutions. More attention should be given to sex differences in factors affecting health care utilization.
Highlights
Women have a longer life expectancy than men but utilize more health care services due to high morbidity [1,2,3,4,5]
Universal health coverage is provided through social health insurance, but there is a sex difference in hospital outpatient department (OPD) visits, and factors related to socioeconomic status have a significant effect, especially on women’s selection of health care institutions
This study analyzed the 2009–2016 data of the Korea Health Panel Survey (KHPS), a government-approved statistical survey carried out under joint supervision of the Korea Institute for Health and Social Affairs and the National Health Insurance Service. This survey has been carried out every year since 2008, and examines the amount of health care utilization, including hospitalization, outpatient visits, medication, and medical expenditures, and main behaviors related to health care utilization and financial resources such as voluntary health insurance
Summary
Women have a longer life expectancy than men but utilize more health care services due to high morbidity [1,2,3,4,5]. Not all studies show consistent results in sex differences in health care utilization, as results differ depending on type of health care service. There have been many studies on the reasons for sex differences in health care utilization, but the results are inconsistent. Previous studies have defined factors related to reproductive health, such as pregnancy and childbirth [12,13,14], the higher morbidity in women than men, the sex difference in recognizing or reporting a disease or symptom [1,12,15,16], and the existence of a sex difference in the. Public Health 2019, 16, 5028; doi:10.3390/ijerph16245028 www.mdpi.com/journal/ijerph
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