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Cited by 119Sex and Gender in HealthcarePrimary Care and Health OutcomesHealth disparities and outcomes

Do men avoid seeking medical advice? A register-based analysis of gender-specific changes in primary healthcare use after first hospitalisation at ages 60+ in Denmark

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Höhn, Andreas, Gampe, Jutta, Lindahl-Jacobsen, Rune, Christensen, Kaare, Oksuyzan, Anna·2020·Journal of Epidemiology and Community Health
DOI 10.1136/jech-2019-213435PMC PMC7337231
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Abstract

Background: It remains unclear whether women’s greater primary healthcare use reflects a lower treatment-seeking threshold or a health disadvantage. We address this question by studying primary healthcare use surrounding a major health shock. Methods: This cohort study utilises routinely-collected healthcare data covering the Danish population aged 60+ years between 1996 and 2011. Using a hurdle model, we investigate levels of non-use and levels of primary healthcare use before and after first inpatient hospitalisation for stroke, myocardial infarction (MI), chronic obstructive pulmonary disease (COPD) and gastrointestinal cancers (GIC). Results: Before hospitalisation, irrespective of cause, men were more likely than women to be non-users of primary healthcare (OR (95% CI): stroke 1.802 (1.731 to 1.872); MI 1.841 (1.760 to 1.922); COPD 2.160 (2.028 to 2.292); GIC 1.609 (1.525 to 1.693)). Men who were users had fewer primary healthcare contacts than women (proportional change (e β) (95% CI): stroke 0.821 (0.806 to 0.836); MI 0.796 (0.778 to 0.814); COPD 0.855 (0.832 to 0.878); GIC 0.859 (0.838 to 0.881)). Following hospitalisation, changes in the probability of being a non-user (OR (95% CI): stroke 0.965 (0.879 to 1.052); MI 0.894 (0.789 to 0.999); COPD 0.755 (0.609 to 0.900); GIC 0.895 (0.801 to 0.988)) and levels of primary healthcare use (e β (95% CI): stroke 1.113 (1.102 to 1.124); MI 1.112 (1.099 to 1.124); COPD 1.078 (1.063 to 1.093); GIC 1.097 (1.079 to 1.114)) were more pronounced among men. Gender differences widened after accounting for survival following hospitalisation. Conclusion: Women’s consistently higher levels of primary healthcare use are likely to be explained by a combination of a lower treatment-seeking threshold and a health disadvantage resulting from better survival in bad health.

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  • Male people with dementia may struggle to express their needs effectively due to culturally expected gender roles and may also experience different social expectations or support dynamics that result in more unmet needs.

    “Additionally, male PWD may struggle to express their needs effectively due to culturally expected gender roles and may also experience different social expectations or support dynamics that result in more unmet needs. e.g., in primary care, men usually seek less medical advice than women [27, 28].”

    From Unmet Needs in Dementia Care: The Predictive Role of Caregiver Challenges (2025) · cites this paper as [27]

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Cited by

Sorted by citations

  • Unmet Needs in Dementia Care: The Predictive Role of Caregiver Challenges

    Bertola, L., da Mata, F., Ramos, A. A., Godoy, C., de Faria, F. M., Lucchetta, R., de Oliveira Junior, H. A., & Ferri, C. P. (2025) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.70164 · Cited by 2 · see citing works

    “Additionally, male PWD may struggle to express their needs effectively due to culturally expected gender roles and may also experience different social expectations or support dynamics that result in more unmet needs. e.g., in primary care, men usually seek less medical advice than women [27, 28].”

Authors
Höhn, A., Gampe, J., Lindahl-Jacobsen, R., Christensen, K., & Oksuyzan, A.
Affiliations
  • University of Southern Denmark (DK)
  • Max Planck Institute for Demographic Research (DE)
  • Department of Epidemiology, Biostatistics, and Biodemography, University of Southern Denmark, Odense C, Denmark
  • Max Planck Institute for Demographic Research, Rostock, Germany
Corresponding author
Höhn, Andreas
ORCID
Venue
Journal of Epidemiology and Community Health
Publisher
BMJ
Published
2020-04-17
Volume
74
Issue
7
Pages
573-579
ISSN
  • 0141-7681 (ISSN-L)
  • 0143-005X
  • 1470-2738
DOI
10.1136/jech-2019-213435
PMC
PMC7337231
OpenAlex
W3016945764
Cited by
119
References
2
Citations by year
2026: 32 · 2025: 37 · 2024: 28 · 2023: 9 · 2022: 6 · 2021: 7
FWCI
4.12
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Epidemiology & Community Health (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion, cc-by-nc)
  • ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion, cc-by-sa)
  • HighWire Press Open Archive (submittedVersion)
  • PUB – Publications at Bielefeld University (Bielefeld University) (submittedVersion, cc-by-nc)
  • Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by-nc)
  • St Andrews Research Repository (St Andrews Research Repository) (submittedVersion, cc-by-nc)
Funders
  • Velux Stiftung
  • Max-Planck-Gesellschaft
  • National Institute on Aging (P01AG031719, R01AG026786)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
  • Social Sciences › Health › Health disparities and outcomes
Keywords
gender differences, treatment-seeking behavior, hospitalization, stroke, myocardial infarction, chronic obstructive pulmonary disease, gastrointestinal cancer, older adults, sex differences
MeSH terms
Aged, Aged, 80 and over, Attitude to Health, Female, Gastrointestinal Neoplasms, Health Services, Hospitalization, Humans, Male, Middle Aged, Myocardial Infarction, Primary Health Care, Sex Factors, Sex Distribution, Stroke, Pulmonary Disease, Chronic Obstructive

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