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Health Status Health Services Health Care Reform Diverse Communities of Women
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Health Care Utilization and Gender: A Pilot Study Using the BC Linked Health Data Arminée Kazanjian, Isabelle Savoie and Denise Morettin, BC Office of Health Technology Assessment
Objectives The goal of this pilot study was to evaluate the feasibility of linking large administrative databases, related to the different programs of the Provincial Ministry of Health, to conduct a population-based study of health care use and gender in British Columbia. We wanted to know if we could use the databases to discover if men and women use health services differently. Did they use selected medical procedures differently? Could analysis of the BC Linked Health Data be used to quantify the relevance of gender in the use of health services and help achieve a better understanding of women’s health issues? The specific objectives of the pilot study were to evaluate the feasibility of using the BC Linked Health Data to: a) Describe the volume and type of health services used by women. b) Examine the relationship between determinants of health (including gender, family structure and socioeconomic status) and the use of health services. c) Explore the measurement of health outcomes relevant to women. Our hypotheses were that differences in women’s and men’s family-related roles are manifested in patterns of health care utilization and that socioeconomic status combined with family structure will result in different patterns in the use of health services. Methods To select the data, we linked each of the Medical Services Plan and Hospital Admission and Separations databases separately to a Co-rdinating File, based on the provincial Registration and Premium Billing files. To safeguard the anonymity of individuals, we assigned study identifiers rather than using individuals’ medical services contract numbers. Data analysis of health services utilization was conducted for the 1996/1997 fiscal year. The dependent number on the Registration and Premium Billing contract was used to establish whether there were dependent children (under 18 years old) in the family (a proxy measure for family structure). Family structure categories (single male; single female; one-adult with children, etc.) were determined by the sex of the contract holder, the sex of a second adult and whether children were listed as dependents. Premium subsidy level was used as a proxy measure for socioeconomic status. Coronary heart disease and depression were chosen as two conditions, respectively representing an acute and a chronic condition. The medical procedures we looked at included hospitalization for depression and revascularization for coronary heart disease. Our sample consisted of 97,840 individuals (49,354 unique families): 49,301 females (50.4%), 48,486 males. 25% of the sample was children. Findings
The BC Linked Health Data and the methodology we developed in this study offer exceptional opportunities for more complex and rigorous research on women’s health and health care utilization, and on the interaction between disease and social roles and the life-course. For further information contact: |
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