Norovirus: ¿un huésped más en residencias de la tercera edad? / Norovirus: One more guest in residential homes for the elderly?

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[Referrals and sex of physicians and patients: a gender analysis, Andalussia, Spain]. / Derivaciones en los centros de salud de Andalucía según el sexo de profesionales y pacientes: un análisis de género.

BACKGROUND: It has been identified differences of medical care practice in primary care related to physician's sex. Simultaneously, there are gender inequalities in the assignment of health resources. Both aspects give rise to an increasing growing interest in the management and provision of health services. OBJECTIVES: To examine the differences in the referral practice made by female and male primary care physicians working in health centers in Andalusia, to consider whether there are disparities in referrals received by men and women, and to examine the interaction between patient's sex and physician's sex. METHODS: Observational, cross-sectional, and multicenter study. POPULATION: 4 health districts in Andalucía and their physicians. SAMPLE: 382 physicians. MEASUREMENTS: referral rate per visit (RV), referral rate per patient quota (RQ), patient's sex, physician: sex, age, postgraduate family medicine specialty, size of the patient quota by sex, mean number of patients/day by sex, mean age of the patient quota by sex, and proportion of men in the quota. Health center: urban / rural, size of the team, enrolled population, and postgraduate family medicine specialty's accreditation. SOURCES: databases of health districts. PERIOD OF STUDY: 2010. ANALYSIS: Bivariate and multivariate multilevel analysis of the referral rate per visit with mixed Poisson model. RESULTS: In 2010 382 physicians made 129,161 referrals to specialized care. The RQ was 23.47 and the RV was 4.92. The RQ in women and men was 27.23 and 19.78 for women physicians, being 27.37 and 19.51 for male physicians. The RV in women and men was 4.92 and 5.48 for women physicians, being 4.54 and 4.93 for male physicians. CONCLUSION: There are no differences in referral according to physician's sex. However, there are signs that might indicate the existence of gender inequality, and women patient received less referrals. There are no physician-patient's sex interaction.

Derivaciones en los centros de salud de Andalucía según el sexo de profesionales y pacientes. Un análisis de género / Referrals and sex of physicians and patients. A gender analysis, Andalussia, Spain

Fundamento: En atención primaria se han identificado diferencias de práctica según sexo del profesional y, simultáneamente, existen des- igualdades de género en la asignación de recursos sanitarios, aspectos ambos que suscitan un interés creciente en la gestión y provisión de servicios de salud. El objetivo del estudio es conocer si existen diferencias de práctica en las derivaciones sanitarias realizadas por médicas y médicos de familia (MF) de centros de salud de Andalucía, si existen desigualdades en las derivaciones recibidas por hombres y mujeres, y si existe inter- acción sexo de profesional sexo de paciente. Métodos: Estudio transversal y multicéntrico. Población: MF de 4 distritos sanitarios (DDSS). Muestra: 382 MF. Variables: tasa de derivaciones por visita (TDxV), tasa de derivaciones por cupo (TDxC), sexo de paciente; sexo, edad, y formación postgraduada en medicina familiar de MF, tamaño del cupo por sexo, media de visitas /paciente por sexo, edad media del cupo por sexo, y proporción de hombres en el cupo; centro de salud urbano/rural, tamaño del equipo, población adscrita y acreditación docente. Fuentes: bases de datos de los DDSS. Análisis estadístico: descriptivo. Bivariante y multivariante mediante análisis multinivel de la TDxV con modelo mixto de Poisson. Resultados: En 2010 los/as 382 MF realizaron 129.161 derivaciones a especialistas. La TDxC fue 23,47 y la TDxV es 4,92. Las TDxC de las médicas fue 27,23 en mujeres y 19,78 en hombres y las de los médicos 27,37 en mujeres y 19,51 en hombres. La TDxV de las médicas fueron 4,92 en mujeres y 5,48 en hombres y para los médicos 4,54 y 4,93 respectivamente. Conclusiones: No existen diferencias en las derivaciones según sexo de las mujeres son menos derivadas. No existe interacción sexo profesional-sexo paciente (AU)

Background: It has been identified differences of medical care practice in primary care related to physician’s sex. Simultaneously, there are gender inequalities in the assignment of health resources. Both aspects give rise to an increasing growing interest in the management and provi- sion of health services. Objectives: To examine the differences in the referral practice made by female and male primary care physicians working in health centers in Andalusia, to consider whether there are disparities in referrals received by men and women, and to examine the interaction bet- ween patient’s sex and physician’s sex. Methods: Observational, cross-sectional, and multicenter study. Population: 4 health districts in Andalucía and their physicians. Sample: 382 physicians. Measurements: referral rate per visit (RV), referral rate per patient quota (RQ), patient's sex, physician: sex, age, postgraduate family medicine specialty, size of the patient quota by sex, mean number of patients/day by sex, mean age of the patient quota by sex, and proportion of men in the quota. Health center: urban / rural, size of the team, enrolled population, and postgraduate family medicine specialty's accreditation. Sources: databases of health districts. Period of study: 2010. Analysis: Bivariate and multivariate multilevel analysis of the referral rate per visit with mixed Poisson model. Results: In 2010 382 physicians made 129,161 referrals to specialized care. The RQ was 23.47 and the RV was 4.92. The RQ in women and men was 27.23 and 19.78 for women physicians, being 27.37 and 19.51 for male physicians. The RV in women and men was 4.92 and 5.48 for women physicians, being 4.54 and 4.93 for male physicians. Conclusion: There are no differences in referral according to physician´s sex. However, there are signs that might indicate the existence of men patient received less referrals. There are no physician-patient's sex interaction (AU)