Gender Differences in Seeking Health Care: Evidence From India

This study examines gender differentials in seeking medical care, in light of the healthcare costs faced by households. 

Background
This study examines whether females seek medical care at systematically lower rates than males. The major objectives to the study are: First, document gender differences in health-care, specifically, in waiting times to first treatment. Using measures of disease intensity (see above), we will evaluate the extent to which eye health has deteriorated before men and women seek care. Second, document gender differences in the probability of follow-up visits conditional on similar levels of health at the first stage of evaluation. Third, understand the underlying reasons for the observed health differences across gender. It is obvious that a plethora of factors must come into play. Without underestimating the importance of any of these, the researchers emphasize the economics of gender differentials in care. Specifically, they propose a careful economic analysis of how the costs faced by households affect the decisions of men and women to seek care.
Approach
Data from the Aravind Eye Hospital — a network of eye-care facilities based in Madurai, India was used for the analysis.  A database of over 60,000 patients was drawn from Aravind’s Madurai district catchment area, collected between May and August of 2012. The database spans the paid hospital and subsidized hospital in the district capital, Madurai, as well as numerous vision centers and eye camps that operated in the region over this period. 

Key Findings

At the time of presentation to an eye care facility, women have worse diagnoses than men across all available indicators of symptomatic illness. They have lower visual acuity and pinhole visual acuity, are more likely to be sight-impaired, and are more likely to be advised surgery or diagnosed for cataract. In contrast, males and females do not differ significantly in their best corrected visual acuity and there are no gender differences in other indicators of surgical care – time to surgery, surgery duration, the incidence of post-operative complications, and the seniority of attending medical personnel. For asymptomatic disease, there is no significant difference between males and females: intraocular eye pressure and a high cup-to-disk ratio, which are correlates of glaucoma, are not significantly different across gender. 

Implications
The findings for symptomatic illness suggest that women seek treatment later than men for perceptible illness. That no such gender differential exists for asymptomatic disease suggests that women do not necessarily go for preventive checkups at a lower frequency than men.