-
Tytuł:
-
Sex differences in the trajectories to diagnosis of patients presenting with common somatic symptoms in primary care: an observational cohort study.
-
Autorzy:
-
Ballering AV; University of Groningen, University Medical Center of Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands, P.O. Box 30.001, 9700, RB, Groningen, the Netherlands. Electronic address: .
Muijres D; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands. P.O. Box 9101, 6500, HB, Nijmegen, the Netherlands. Electronic address: .
Uijen AA; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands. P.O. Box 9101, 6500, HB, Nijmegen, the Netherlands. Electronic address: .
Rosmalen JGM; University of Groningen, University Medical Center of Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands, P.O. Box 30.001, 9700, RB, Groningen, the Netherlands. Electronic address: .
Olde Hartman TC; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands. P.O. Box 9101, 6500, HB, Nijmegen, the Netherlands. Electronic address: .
-
Źródło:
-
Journal of psychosomatic research [J Psychosom Res] 2021 Oct; Vol. 149, pp. 110589. Date of Electronic Publication: 2021 Jul 31.
-
Typ publikacji:
-
Journal Article; Observational Study; Research Support, Non-U.S. Gov't
-
Język:
-
English
-
Imprint Name(s):
-
Publication: Oxford : Pergamon Press
Original Publication: London.
-
MeSH Terms:
-
Medically Unexplained Symptoms*
Cohort Studies ; Female ; Humans ; Male ; Physical Examination ; Primary Health Care ; Sex Characteristics
-
Contributed Indexing:
-
Keywords: Common somatic symptoms; General practice; Medically unexplained symptoms; Primary care; Sex differences
-
Entry Date(s):
-
Date Created: 20210813 Date Completed: 20211124 Latest Revision: 20211124
-
Update Code:
-
20240105
-
DOI:
-
10.1016/j.jpsychores.2021.110589
-
PMID:
-
34385033
-
Objective: Little insight exists into sex differences in diagnostic trajectories for common somatic symptoms. This study aims to quantify sex differences in the provided primary care diagnostic interventions for common somatic symptoms, as well as the consequences hereof for final diagnoses.
Methods: In this observational cohort study, we used real-world clinical data from the Dutch Family Medicine Network (N = 34,268 episodes of care related to common somatic symptoms; 61,4% female). The association between patients' sex on the one hand, and diagnostic interventions and disease diagnoses on the other hand, were assessed using multilevel multiple logistic regression analyses. Structural equation modelling was used to estimate a mediation model with multiple parallel mediators to assess whether the fewer disease diagnoses given to female patients were mediated by the fewer diagnostic interventions female patients receive, compared to male patients.
Results: Women received fewer physical examinations (OR = 0.84, 95%CI = 0.79-0.89), diagnostic imaging (OR = 0.92, 95%CI = 0.84-0.99) and specialist referrals (OR = 0.85, 95%CI = 0.79-0.91) than men, but more laboratory diagnostics (OR = 1.27, 95%CI = 1.19-1.35). Women received disease diagnoses less often than men for their common somatic symptoms (OR = 0.94, 95%CI = 0.89-0.98). Mediation analysis showed that the fewer disease diagnosis in female patients were mediated by the fewer diagnostic interventions conducted in women compared to men.
Conclusion: This study shows that sex inequalities are present in primary care diagnostic trajectories of patients with common somatic symptoms and that these lead to unequal health outcomes in terms of diagnoses between women and men. FPs have to be aware of these inequalities to ensure equal high-quality care for all patients.
(Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)
