an evaluation of gender equity in different models of primary care practices in ontario性别平等的评价不同型号的初级护理实践在安大略省.pdfVIP

Dahrouge et al. BMC Public Health 2010, 10:151 /1471-2458/10/151 RESEARCH ARTICLE Open Access An evaluation of gender equity in different models of primary care practices in Ontario 1* 1,2,3 1 1,2,3 3 3,4 Simone Dahrouge , William Hogg , Meltem Tuna , Grant Russell , Rose Anne Devlin , Peter Tugwell , Elisabeth Kristjansson4 Abstract Background: The World Health Organization calls for more work evaluating the effect of health care reforms on gender equity in developed countries. We performed this evaluation in Ontario, Canada where primary care models resulting from reforms co-exist. Methods: This cross sectional study of primary care practices uses data collected in 2005-2006. Healthcare service models included in the study consist of fee for service (FFS) based, salaried, and capitation based. We compared the quality of care delivered to women and men in practices of each model. We performed multi-level, multivariate regressions adjusting for patient socio-demographic and economic factors to evaluate vertical equity, and adjusting for these and health factors in evaluating horizontal equity. We measured seven dimensions of health service delivery (e.g. accessibility and continuity) and three dimensions of quality of care using patient surveys (n = 5,361) and chart abstractions (n = 4,108). Results: Health service delivery measures were comparable in women and men, with differences ≤ 2.2% in all seven dimensions and in all models. Significant gender differences in the health promotion subjects addressed were observed. Female specific preventive manoeuvres were more likely to be performed than other preventive care. Men attending FFS practices were more likely t