Gender differences in the use of health care in China: cross-sectional analysis

INTRODUCTION: Differences between women and men in education, employment, political and economic empowerment have been well-documented in China due to the long traditional culture that male is superior to female. This study is to explore whether the similar gender differences exist in the use of health care by analyzing hospital admission, duration of hospitalization and medical expense of both genders in a Chinese hospital. METHODS: This cross-sectional study evaluated the gender differences in clinical and epidemiologic characteristics of patients who were admitted for any reason to hospital in Zhuhai Special Economic Zone, Southern China, from January 1, 2003, through December 31, 2009. Chi-square test was used to calculate differences between proportions and the t test was used to test differences between means. RESULTS: A total of 156,887 patients were recruited in the analysis, with a male/female ratio of 1.1:1.0. The average age and the duration of hospitalization were significantly greater among men (p < 0.05). A larger proportion of hospitalized female underwent surgery compared to male (p < 0.05). The total medical expense per inpatient indicated important differences between genders, with higher expenditures observed among men (p < 0.05). Furthermore, gender differences were observed in length of hospitalization and medical expense for five common conditions respectively and most differences favoring men were significant (p < 0.05) while differences favoring women were not significant (p > 0.05). Among all the self-paid patients, men were also superior in all investigating variables compared with women. CONCLUSIONS: Gender differences in the use of health care do occur in China. Despite of demographic factors, the differences between female and male can be in part explained by social power relations. China should increase attention to gender and equity in health.