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Alexandre Kalache

Publications and source records attributed to Alexandre Kalache.

5 recordsLinked to original sources

Does health status explain gender dissimilarity in healthcare use among older adults?

This study investigates the extent to which gender dissimilarity in healthcare use in later life is explained by variation in health and social-economic statuses. It is based on a nationwide sample in Brazil of 12,757 men and 16,186 women aged 60+ years. Individuals with great difficulties or unable to perform at least one daily living activity and/or to walk 100m were classified as "established disability". Those who had interrupted their activities in the previous 15 days because of a health problem were regarded as "temporarily disabled". The remaining we classified as "healthy". These categories were analyzed by multinomial logistic regression, taking "healthy" as the reference category. Prevalences of established disability were 6% among men and 11% among women. Temporary disabilities were 7.9% and 10.1%, respectively. Poor health status was associated with increased use of healthcare among men and women, but men and women differed significantly in relation to use pattern after adjustment for age, health status, and income. Older women were greater consumers of outpatient services and older men of inpatient care.

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Gender inequalities in health among older Brazilian adults.

OBJECTIVE: To investigate gender differences among older Brazilians in their health status and their use of health services. METHODS: Participants were individuals aged 60 years and older included in a national household survey conducted in Brazil in 1998. Data were analyzed by multiple logistic regression, taking into account the design effect due to multistage sampling. RESULTS: There were differences in the health and living conditions of older men and older women that were not explained by age or place of residence. Older women had worse indicators of schooling and personal income but better indicators of housing standards and per capita household income. The older women also reported more chronic diseases, had poorer indicators of independence and physical mobility, sought health services more often, and reported more medical visits in the previous year. Despite their apparent worse health conditions, elderly women in urban areas had lower hospitalization rates in the previous year (odds ratio = 0.89; 95% confidence interval, 0.82-0.96) than did elderly men in urban areas. CONCLUSIONS: Our results indicate that among older Brazilians there are gender inequalities in health that cannot be explained by age and place of residence. The findings raise questions on how health, socioeconomic, and cultural factors influence gender patterns of seeking and using health care in later life in the country. As pressures on health care and health funding increase in Brazil as a result of the aging of the population, there is a need to take a gender perspective into account.

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