Sex differences in the use of health care services.

BACKGROUND Sex differences in the use of health care services can be substantial at several stages of life. However, the extent to which differences in reproductive biology and mortality affect the use of health care services is unclear. METHODS We studied age- and sex-specific per capita use of health care resources for a one-year period during 1994 and 1995 in the Canadian province of Manitoba, where there is universal insurance for a comprehensive range of health care services. Using information obtained from administrative records of physicians' services and acute hospital care, we tabulated the use of health care resources by male and female subjects in three categories: care for conditions specific to sex, care provided to persons who died during the study year, and care provided for all other conditions. RESULTS The crude annual per capita use of health care resources (in Canadian dollars) was greater for female subjects ($1,164) than for male subjects ($918). Approximately 22 percent of health care expenditures for female subjects was associated with conditions specific to sex, including pregnancy and childbirth, as compared with 3 percent of expenditures for male subjects. An estimated 14 percent of health care expenditures for male subjects was consumed by persons who died during the study period, as compared with 10 percent of expenditures for female subjects. After adjustment for the use of health care associated with sex-specific conditions and differences in mortality, the female:male ratio in health care expenditures was reduced from 1.3 to 1.0. CONCLUSIONS Expenditures for health care are similar for male and female subjects after differences in reproductive biology and higher age-specific mortality rates among men have been accounted for.