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Men of all ages have less contact with their family doctor than women, with the gap narrowing with age, and they are more likely to be admitted to hospital and have a greater mortality, according to a study of more than 30 million contacts with GPs and hospital admissions in Denmark in one year (Journal of Public Health 2007 Nov 2 doi: 10.1093/pubmed/fdm072).).
“This is compatible with a scenario in which men react later to severe symptoms than women so that they are more likely to be hospitalised for or die from these conditions,” say the authors.
They say that population based studies indicate that in many aspects men have better health than women—men are stronger, report fewer diseases, and consistently report better health status than women. Although women have greater rates of acute illness, women's mortality is lower than men's for all age groups.
“A prominent hypothesis is that men seek medical advice very late, and the stereotype is that men over-react to small symptoms and under-react to severe symptoms, the latter leading to a poorer prognosis. However, few data are available to support this hypothesis,” say the authors from the National Institute of Public Health, University of Southern Denmark.
In their study, they used the Danish nationwide health registers that cover admissions to hospital and all contact with GPs for the year 2005. Age specific rates for each sex for contact with GPs and for hospital admissions were used to calculate sex ratios by dividing the rates for women by the rates for men.
The final analysis is based on a total of 35.8 million contacts with GPs, and 1.2 million hospital admissions in 2005.
This shows that at all ages women have higher rates of contact with GPs than men, with a peak between ages 15 and 35. Between ages 15 and 50, women also have higher rates of hospital admission. The difference in rates of hospital admission for ages 15-49 is strongly influenced by women's admission to hospital for childbirth. For age 50 and older, men have greater rates of admission to hospital.
“Our data, which are without any selection bias due to the Danish healthcare system and to the nationwide registers, show a male pattern with a lower contact rate to the general practitioner, but higher hospitalisation and mortality rates,” says the report.
The authors add, “The reason why men are reluctant to seek medical advice is probably rooted in biological and psychological factors as well as social traditions. New generations and new initiatives like ‘men's health week' might help to change the male reluctance toward using the health care system.”
Ian Banks, president of the Men's Health Forum in the United Kingdom, said, “This is a very interesting study. From Office for National Statistics data we have seen that men use general practice about half as much as women up until the age of 50, after which it is about equal, and this is the time when we start to pick up all the underlying problems of diabetes, cardiac conditions, and so on.
“It may explain why, for example, while women with diabetes are picked up mainly by GPs and practice nurses, men are mainly picked up in the community by optometrists. That means that if a man has had diabetes long enough to damage the retina, he must have had it for at least eight years.
“We also find that after the age of 50 there are twice as many admissions for men as there are for women. In other words men present less to the GP and more often to accident and emergency, and this is a trend which is very serious not only for men, because whatever is wrong has had that much longer to cause damage, but also because accident and emergency is the most expensive use of health resources.”