The cost of being a woman. A National Study of Health Care Utilization and Expenditures for Female-Specific Conditions
Department of Health Evaluation Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17033-0855, USA. Women s Health Issues
(Impact Factor: 2.33).
01/2007; 17(1):13-21. DOI: 10.1016/j.whi.2006.11.004
An important component of women's health care is for conditions that are exclusive to women, yet little research has addressed the economic impact of health care for these conditions. The purpose of this study was to describe health care utilization for female-specific conditions, the incremental expenditures attributable to these conditions, and the overall incremental expenditures across the lifespan.
We analyzed 3 years of a nationally representative survey of the US noninstitutionalized population, the 2000-2002 National Medical Expenditure Panel Survey, which included 25,361 females aged > or =14, representing 38,170 person-years.
More than one fifth of women (21.2%) reported having a female-specific condition during a 1-year period, the most common of which were gynecologic disorders (7.4%); pregnancy-related conditions (6.4%); and menopausal symptoms (5.3%). The mean increment in annual total expenditures attributable to female-specific conditions ranged from $483 for menopausal disorders to $3,896 for female cancers. The annual total health care expenditures of women with female-specific conditions were estimated to be $108 billion, of which >40% ($43.3 billion) was attributable to female-specific conditions. Women with female-specific conditions who had no health insurance were less likely to have visited a doctor (p = .0002), filled a prescription (p = .001), and been hospitalized (p = .0001) for these conditions, but more likely to have visited an emergency department (p = .02) seeking treatment for these conditions.
In this nationally representative sample of American women aged > or =14, female-specific conditions were common and substantially increased costs of health care.
Available from: Caroline Smith
- "Women specific health complaints are common. Data from the 2000–02 National Medical Expenditure Survey of the USA non institutionalised population reported the annual prevalence of female specific conditions among women aged greater than 14 years to be 21% (Kjerulff et al., 2007). In this survey the most common complaints were gynecological disorders (7.4%), pregnancy related conditions (6.4%), followed by menopausal symptoms (5.3%). "
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ABSTRACT: Women specific health complaints are common, and women are higher users of complementary therapies and medicines. Acupuncture is one modality used by women. The aim of this paper was to summarise the evidence from scientific trials and systematic reviews assessing the effectiveness of acupuncture to treat the most common women specific reproductive health complaints.
We conducted a search of the major databases PubMed, CINAHL, and the Cochrane Library from their inception to Sept 2009, to obtain English language texts of randomised controlled trials (RCTs) and systematic reviews. The following English Australian search terms were used: acupuncture and period pain or dysmenorrhea, or premenstrual syndrome, or poly cystic ovarian syndrome/PCOS, or menstrual headache, or irregular periods/menstruation, or amenorrhea, or heavy menses/periods, or menorrhagia, or menopause, and randomised controlled trial and systematic review. Both authors extracted data and reviewed each trial and systematic review for methodological quality.
Five systematic reviews were included, and six RCTs. The symptoms of the menopause and dysmenorrhea have been subject to greater clinical evaluation through RCTs, and the evidence summarised in systematic reviews, than any other reproductive health complaint. The evidence for acupuncture to treat dysmenorrhea and menopause remains unclear, due to small study populations and the presence of methodological bias. Acupuncture to treat PMS, PCOS and other menstrual related symptoms is under-studied, and the evidence for acupuncture to treat these conditions is frequently based on single studies.
Further research is needed.
Available from: Joseph Goulet
- "Gender differences in health care use are a combination of interacting economic, social, psychological and biological factors. Although, men aged more than ≥ 59 years have higher health care utilization than women of the same age, younger women report higher use of health care services than men during their child bearing years [5,6]. These differences may be associated with reproductive biology, gender-specific conditions and higher morbidity rates in women in this age group [5,7-10]. "
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ABSTRACT: The number of women serving in the United States military increased during Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), leading to a subsequent surge in new women Veterans seeking health care services from the Veterans Administration (VA). The objective of this study was to examine gender differences among OEF/OIF Veterans in utilization of VA outpatient health care services.
Our retrospective cohort consisted of 1,620 OEF/OIF Veterans (240 women and 1380 men) who enrolled for outpatient healthcare at a single VA facility. We collected demographic data and information on military service and VA utilization from VA electronic medical records. To assess gender differences we used two models: use versus nonuse of services (logistic regression) and intensity of use among users (negative binomial regression).
In our sample, women were more likely to be younger, single, and non-white than men. Women were more likely to utilize outpatient care services (odds ratio [OR] = 1.47, 95% confidence interval [CI]:1.09, 1.98), but once care was initiated, frequency of visits over time (intensity) did not differ by gender (incident rate ratio [IRR] = 1.07; 95% CI: 0.90, 1.27).
Recently discharged OEF/OIF women Veterans were more likely to seek VA health care than men Veterans. But the intensity of use was similar between women and men VA care users. As more women use VA health care, prospective studies exploring gender differences in types of services utilized, health outcomes, and factors associated with satisfaction will be required.
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ABSTRACT: Menstrual cycle-related symptoms are associated with the intrinsic hormonal fluctuations of the menstrual cycle. These symptoms can be physical, behavioral, or emotional and include problems such as dysmenorrhea, premenstrual syndrome (PMS), and premenstrual dysphoric disorder (PMDD). Because of the emotional and behavioral aspects of menstrual cycle-related symptoms, it is likely that clinical psychiatrists will encounter these symptoms in their daily practice and should therefore be familiar with their diagnosis, prevalence, etiology, and treatment. As many as 2.5 million women are affected by menstrual disorders each year, which can have a profound impact on their quality of life. Although a definitive etiology has yet to be established, fluctuations in estrogen and progesterone as well as genetic factors are thought to contribute to the occurrence of menstrual disorders. Current treatment options include nonsteroidal anti-inflammatory drugs (NSAIDs) (for dysmenorrhea), lifestyle changes, selective serotonin reuptake inhibitors (SSRIs), and ovulation suppression (e.g., with oral contraceptives). Treatment with oral contraceptives (OCs), particularly extended or continuous use, may significantly reduce the incidence of menstrual cycle-related symptoms.
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