The gender gap in primary health care resource utilization in Central Asia
There is a large gender gap in life expectancy in some countries of the former Soviet Union. Life expectancy of males is as much as 13 years less than that of females, and a significant portion of the excess male mortality is caused by cardiovascular disease. Although effective primary health care i...
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| Veröffentlicht in: | Health policy and planning 2002-09, Vol.17 (3), p.264-272 |
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| creator | Cashin, Cheryl E Borowitz, Michael Zuess, Olga |
| description | There is a large gender gap in life expectancy in some countries of the former Soviet Union. Life expectancy of males is as much as 13 years less than that of females, and a significant portion of the excess male mortality is caused by cardiovascular disease. Although effective primary health care is necessary to manage cardiovascular disease and reduce acute episodes and mortality, the primary health care system is under-utilized by adult males in the region. This study combines disaggregated utilization data with cost data to analyze patterns of per capita primary care resource consumption in urban and rural regions of Kazakhstan and Uzbekistan. The results show that both in absolute and per capita terms, the principal users of primary health are women of reproductive age and children under five. Based on a combination of utilization and cost of services, women of reproductive age consume approximately 1.5 times the average per capita primary health care resources, while men in the same age group consume approximately one-half of the average. Children under five consume about three to five times the average per capita primary care resources. Based on the results of the study, regional government health purchasers worked together with providers to develop a new per capita payment system with age/sex adjustments and incentives for outreach to bring adult men into the primary care system. |
| doi_str_mv | 10.1093/heapol/17.3.264 |
| format | Article |
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Life expectancy of males is as much as 13 years less than that of females, and a significant portion of the excess male mortality is caused by cardiovascular disease. Although effective primary health care is necessary to manage cardiovascular disease and reduce acute episodes and mortality, the primary health care system is under-utilized by adult males in the region. This study combines disaggregated utilization data with cost data to analyze patterns of per capita primary care resource consumption in urban and rural regions of Kazakhstan and Uzbekistan. The results show that both in absolute and per capita terms, the principal users of primary health are women of reproductive age and children under five. Based on a combination of utilization and cost of services, women of reproductive age consume approximately 1.5 times the average per capita primary health care resources, while men in the same age group consume approximately one-half of the average. Children under five consume about three to five times the average per capita primary care resources. Based on the results of the study, regional government health purchasers worked together with providers to develop a new per capita payment system with age/sex adjustments and incentives for outreach to bring adult men into the primary care system.</description><identifier>ISSN: 0268-1080</identifier><identifier>ISSN: 1460-2237</identifier><identifier>EISSN: 1460-2237</identifier><identifier>DOI: 10.1093/heapol/17.3.264</identifier><identifier>PMID: 12135992</identifier><identifier>CODEN: HPOPEV</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adolescent ; Adult ; Age ; Age Distribution ; Asia, Central - epidemiology ; Capitation financing ; Cardiovascular disease ; Cardiovascular diseases ; Central Asia ; Child ; Child, Preschool ; Cost control ; Disease prevention ; Efficiency ; Female ; Females ; Gender ; Gender equity ; Gender inequalities ; Health ; Health administration ; Health care ; Health care expenditures ; Health care policy ; Health Care Rationing - methods ; Health Care Surveys ; Health planning ; Health services ; Humans ; Incentives ; Kazakhstan - epidemiology ; Life Expectancy ; Male ; Males ; Medical diagnosis ; Middle Aged ; Mortality ; Patient satisfaction ; Payment systems ; Per capita ; Population ; Prevention ; Preventive medicine ; Primary care ; Primary health care ; Primary Health Care - statistics & numerical data ; Resource consumption ; Resource utilization ; Rural areas ; Sex Distribution ; Uzbekistan - epidemiology ; Womens health</subject><ispartof>Health policy and planning, 2002-09, Vol.17 (3), p.264-272</ispartof><rights>2002 Oxford University Press</rights><rights>Copyright Oxford University Press(England) Sep 2002</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-f422ae41684c00dc2862229f400738393731bdd723722c3ce32c2db8f43744ea3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/45089788$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/45089788$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,776,780,799,27845,27903,27904,30978,30979,57996,58229</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12135992$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cashin, Cheryl E</creatorcontrib><creatorcontrib>Borowitz, Michael</creatorcontrib><creatorcontrib>Zuess, Olga</creatorcontrib><title>The gender gap in primary health care resource utilization in Central Asia</title><title>Health policy and planning</title><addtitle>Health Policy Plan</addtitle><description>There is a large gender gap in life expectancy in some countries of the former Soviet Union. Life expectancy of males is as much as 13 years less than that of females, and a significant portion of the excess male mortality is caused by cardiovascular disease. Although effective primary health care is necessary to manage cardiovascular disease and reduce acute episodes and mortality, the primary health care system is under-utilized by adult males in the region. This study combines disaggregated utilization data with cost data to analyze patterns of per capita primary care resource consumption in urban and rural regions of Kazakhstan and Uzbekistan. The results show that both in absolute and per capita terms, the principal users of primary health are women of reproductive age and children under five. Based on a combination of utilization and cost of services, women of reproductive age consume approximately 1.5 times the average per capita primary health care resources, while men in the same age group consume approximately one-half of the average. Children under five consume about three to five times the average per capita primary care resources. Based on the results of the study, regional government health purchasers worked together with providers to develop a new per capita payment system with age/sex adjustments and incentives for outreach to bring adult men into the primary care system.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Age Distribution</subject><subject>Asia, Central - epidemiology</subject><subject>Capitation financing</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Central Asia</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cost control</subject><subject>Disease prevention</subject><subject>Efficiency</subject><subject>Female</subject><subject>Females</subject><subject>Gender</subject><subject>Gender equity</subject><subject>Gender inequalities</subject><subject>Health</subject><subject>Health administration</subject><subject>Health care</subject><subject>Health care expenditures</subject><subject>Health care policy</subject><subject>Health Care Rationing - methods</subject><subject>Health Care Surveys</subject><subject>Health planning</subject><subject>Health services</subject><subject>Humans</subject><subject>Incentives</subject><subject>Kazakhstan - epidemiology</subject><subject>Life Expectancy</subject><subject>Male</subject><subject>Males</subject><subject>Medical diagnosis</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Patient satisfaction</subject><subject>Payment systems</subject><subject>Per capita</subject><subject>Population</subject><subject>Prevention</subject><subject>Preventive medicine</subject><subject>Primary care</subject><subject>Primary health care</subject><subject>Primary Health Care - statistics & numerical data</subject><subject>Resource consumption</subject><subject>Resource utilization</subject><subject>Rural areas</subject><subject>Sex Distribution</subject><subject>Uzbekistan - epidemiology</subject><subject>Womens health</subject><issn>0268-1080</issn><issn>1460-2237</issn><issn>1460-2237</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>7TQ</sourceid><recordid>eNqFkUGP0zAQhS0EYsvCmRPI4sAtrWfGie3jqgIKWsRlEYiL5TrONiVNunYiAb8eV6kWicue5vC-eaN5j7GXIJYgDK12wR2HbgVqSUus5CO2AFmJApHUY7YQWOkChBYX7FlKeyFASlk-ZReAQKUxuGCfbnaB34a-DpHfuiNve36M7cHF3zx7d-OOexcDjyENU_SBT2PbtX_c2A79iV2Hfoyu41epdc_Zk8Z1Kbw4z0v29f27m_WmuP7y4eP66rrwUtNYNBLRBQmVll6I2qOuENE0UghFmgwpgm1dq_wCoicfCD3WW91IUlIGR5fs7ex7jMPdFNJoD23yoetcH4YpWQWGQFD1IFhmP4NKPAiSAQEAMoNv_gP3OZY-f2sx54xGVjpDqxnycUgphsaeE7Ug7Kk1O7dmQVmyubW88fpsO20Pof7Hn2vKwKsZ2KdxiPe6LIU2Sp9OFrPepjH8utdd_GkrRaq0m-8_rPmMG7P5trZAfwEdC6oH</recordid><startdate>20020901</startdate><enddate>20020901</enddate><creator>Cashin, Cheryl E</creator><creator>Borowitz, Michael</creator><creator>Zuess, Olga</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7T2</scope><scope>7TQ</scope><scope>8BJ</scope><scope>C1K</scope><scope>DHY</scope><scope>DON</scope><scope>FQK</scope><scope>JBE</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20020901</creationdate><title>The gender gap in primary health care resource utilization in Central Asia</title><author>Cashin, Cheryl E ; Borowitz, Michael ; Zuess, Olga</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c483t-f422ae41684c00dc2862229f400738393731bdd723722c3ce32c2db8f43744ea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Age Distribution</topic><topic>Asia, Central - epidemiology</topic><topic>Capitation financing</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Central Asia</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cost control</topic><topic>Disease prevention</topic><topic>Efficiency</topic><topic>Female</topic><topic>Females</topic><topic>Gender</topic><topic>Gender equity</topic><topic>Gender inequalities</topic><topic>Health</topic><topic>Health administration</topic><topic>Health care</topic><topic>Health care expenditures</topic><topic>Health care policy</topic><topic>Health Care Rationing - methods</topic><topic>Health Care Surveys</topic><topic>Health planning</topic><topic>Health services</topic><topic>Humans</topic><topic>Incentives</topic><topic>Kazakhstan - epidemiology</topic><topic>Life Expectancy</topic><topic>Male</topic><topic>Males</topic><topic>Medical diagnosis</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Patient satisfaction</topic><topic>Payment systems</topic><topic>Per capita</topic><topic>Population</topic><topic>Prevention</topic><topic>Preventive medicine</topic><topic>Primary care</topic><topic>Primary health care</topic><topic>Primary Health Care - statistics & numerical data</topic><topic>Resource consumption</topic><topic>Resource utilization</topic><topic>Rural areas</topic><topic>Sex Distribution</topic><topic>Uzbekistan - epidemiology</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cashin, Cheryl E</creatorcontrib><creatorcontrib>Borowitz, Michael</creatorcontrib><creatorcontrib>Zuess, Olga</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>PAIS Index</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>International Bibliography of the Social Sciences</collection><collection>International Bibliography of the Social Sciences</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Health policy and planning</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cashin, Cheryl E</au><au>Borowitz, Michael</au><au>Zuess, Olga</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The gender gap in primary health care resource utilization in Central Asia</atitle><jtitle>Health policy and planning</jtitle><addtitle>Health Policy Plan</addtitle><date>2002-09-01</date><risdate>2002</risdate><volume>17</volume><issue>3</issue><spage>264</spage><epage>272</epage><pages>264-272</pages><issn>0268-1080</issn><issn>1460-2237</issn><eissn>1460-2237</eissn><coden>HPOPEV</coden><abstract>There is a large gender gap in life expectancy in some countries of the former Soviet Union. Life expectancy of males is as much as 13 years less than that of females, and a significant portion of the excess male mortality is caused by cardiovascular disease. Although effective primary health care is necessary to manage cardiovascular disease and reduce acute episodes and mortality, the primary health care system is under-utilized by adult males in the region. This study combines disaggregated utilization data with cost data to analyze patterns of per capita primary care resource consumption in urban and rural regions of Kazakhstan and Uzbekistan. The results show that both in absolute and per capita terms, the principal users of primary health are women of reproductive age and children under five. Based on a combination of utilization and cost of services, women of reproductive age consume approximately 1.5 times the average per capita primary health care resources, while men in the same age group consume approximately one-half of the average. Children under five consume about three to five times the average per capita primary care resources. Based on the results of the study, regional government health purchasers worked together with providers to develop a new per capita payment system with age/sex adjustments and incentives for outreach to bring adult men into the primary care system.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>12135992</pmid><doi>10.1093/heapol/17.3.264</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); Jstor Complete Legacy; Oxford Journals Open Access Collection; MEDLINE; PAIS Index; Alma/SFX Local Collection; EZB Electronic Journals Library |
| subjects | Adolescent Adult Age Age Distribution Asia, Central - epidemiology Capitation financing Cardiovascular disease Cardiovascular diseases Central Asia Child Child, Preschool Cost control Disease prevention Efficiency Female Females Gender Gender equity Gender inequalities Health Health administration Health care Health care expenditures Health care policy Health Care Rationing - methods Health Care Surveys Health planning Health services Humans Incentives Kazakhstan - epidemiology Life Expectancy Male Males Medical diagnosis Middle Aged Mortality Patient satisfaction Payment systems Per capita Population Prevention Preventive medicine Primary care Primary health care Primary Health Care - statistics & numerical data Resource consumption Resource utilization Rural areas Sex Distribution Uzbekistan - epidemiology Womens health |
| title | The gender gap in primary health care resource utilization in Central Asia |
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