Gender differences in financial barriers to primary health care in New Zealand

Abstract

INTRODUCTION: Gender differences in health status and use of health care services have been established in the developed world with less attention paid to gender differences in financial barriers to primary care. Such barriers represent potentially avoidable mortality and morbidity. AIM: To examine gender differences in financial barriers to New Zealand primary health care. METHODS: Data from SoFIE-health, an add-on to Statistics New Zealand–led Survey of Family, Income and Employment (SoFIE), analysed using logistic regression, controlling for demographic, socioeconomic, health behaviour and health variables. Access to primary health care includes general practitioner and dental care and prescription drugs. RESULTS: Odds of deferring seeing their doctor(s), dentist and buying a prescription respectively at least once during preceding 12 months, because they could not afford the cost of a visit or prescription, were greater for women compared to men (Odds Ratio (OR) 1.82, 95% CI: 1.67–1.99; OR 2.05, 95% CI: 1.78–2.34; and OR 1.58, 95% CI: 1.47–1.71; respectively). Adjusting for demographic, socioeconomic, health behaviour and health status attenuated OR to 1.45 (1.31–1.61) for deferring medical visit, 1.47 (1.26–1.71) buying prescription, and 1.35 (1.24–1.46) for deferring dental visit, although confidence intervals still excluded the null. DISCUSSION: Gender significantly associated with reporting cost barriers to primary health care, regardless of individual deprivation or income levels, suggesting that primary health care policies targeting gender-specific factors are warranted. Policy measures to reduce co-payments may improve access to care for both women and men, and may have positive health implications. KEYWORDS: Gender; primary health care; access barriers; New Zealand