Gender disparities in health and healthcare use among older adults.

Background: Gender differences in health and the use of health services are a long-standing concern for the U.S. medical system. Our purpose was to examine if there are patterns of gender differences in the type of medical service used among older Americans.

Methods: We conducted a prospective study of 9164 Americans aged >or=65 followed through the Health and Retirement Study (HRS), a national probability sample of community dwelling adults. Self-reported medical utilization between 2002 and 2004 was modeled as a function of 2002 baseline characteristics of the sample.

Results: Health needs were substantially greater among older women compared with men, but women had fewer economic resources. Controlling for health needs did little to explain gender differences in preventive care and increased gender differences in the use of hospital services. Women were less likely to have hospital stays (adjusted odds ratio [OR] = 0.79) and had fewer physician visits (3.07 vs. 3.30 median visits within 2 years) than men with similar demographic and health profiles. In contrast, the greater use of home healthcare among women was almost entirely explained by their greater health needs.

Conclusions: These national data show that simple evaluations of age-adjusted gender differences in the use of hospital and physician services that do not account for underlying health needs are in danger of understating these disparities.