Deepa Patel Doctor of Pharmacy Candidate, 2012 Mercer COPHS Presented on July 22, 2011

 Disparities in healthcare by gender can be somewhat linked to the greater need for care throughout the lifespan of a female patient when compared to males  Females have a greater need for reproductive and preventative care during their younger yours  Females also have a greater need for treatment from numerous chronic disease states at an older age  Nearly 80% of women have a usual primary care provider, whereas 72% of males do  Females are more likely to be unable to receive or receiveddelayed medical care, dental care, or prescription medications

 Studies indicate that patients are more receptive to communicating when they are able to relate to the information being presented  Female physicians have demonstrated a greater skill of gathering subjective information from patients

2010 National Healthcare Quality and Disparities Report

 Both genders had decreases in hospitalizations for lower extremity amputation from 2005 to 2007  Males, however, had twice as many admissions as women for diabetes

 The number of female adult hemodialysis patients that were receiving adequate dialysis was higher than that of male adult hemodialysis patients  Males are more likely to be registered on a kidney transplant waiting list

 Leading cause of death  Females had higher rates of inpatient heart attack mortality than men  Rate of receipt of a fibrinolytic medication was higher in males than women  Both male and female patients with heart failure were discharged with appropriate medications at a rate of 82%

 HIV infection death rate for males was more than twice that of females  (5.4 per 100,000 population versus 2.1)

 3 rd most common cancer in adults  Rate of advanced stage colorectal cancer in males are significantly higher than women  The rate for both genders, however, is decreasing significantly

 No differences in the treatment of hospitalized pneumonia patients  Tuberculosis  Both genders increased the percentage of patients who completed therapy  Female patients were more likely to complete treatment when compared to males  Females had lower rates of post operative respiratory failure, sepsis, and deaths following complications of care

 Female patients are 11% more likely to receive treatment for a major depressive episode compared to male patients  Males had suicide rates four times higher than females

 Females are significantly less likely to complete substance abuse treatment, 41% compared to 47.1%

 Pressure ulcers  Both genders had decreases in short and long term stay incidence of ulcers  Females were less likely to have either type  Female patients were more likely to receive potentially inappropriate medications

MaleFemale  Kidney transplant waiting list registration  Inpatient myocardial infarctions  Appropriate medication dispensed  Completion of substance abuse treatment  Diabetes  Adequate dialysis in ESRD  HIV  Colorectal Cancer  Tuberculosis  Post operative respiratory failure  Sepsis  Deaths following complications of care  Major Depressive Disorder  Suicide Attempts  Pressure Ulcers

 Male patients are more likely to be uninsured  Many associate the incidence of women having insurance coverage with increased ease of availability of programs such as Medicaid for children and prenatal care  An argument can be formed that increased needs for healthcare in females makes having insurance a greater need than with male patients

 March 2010: Two federal statutes colloquially referred to as “Health care reform” passed  Patient Protection and Affordable Care Act  Health Care and Education Reconciliation Act  One of the main goals is to expand insurance coverage, particularly to low and moderate income and uninsured adults

 In 2006 the state passed its health care insurance reform law  Parallels goals with National Reform:  State regulated minimum healthcare insurance coverage  Free health care for residents below established income levels even if patient doesn’t qualify for Medicaid  Reduce burden of EMTALA

 “Have Gender Gaps in Insurance Coverage and Access to Care Narrowed under Health Reform? Findings from Massachusetts.”  Cross sectional study based on surveys  Observed differences pre health care reform (2006) and post reform (2009) in adults by gender  Insurance coverage  Access to health care  Use of healthcare  Affordability

 Overall, younger and older women continue to use more care than men under healthcare reform  Despite increases in insurance coverage, women were still more likely to report unmet needs for health care and problems affording care than men  Especially true in younger adults

 Coverage does not always translate to access to healthcare and affordability of care  Particularly in patients with greater healthcare needs, such as women of all age groups  Despite mandated healthcare coverage, affordability is a major concern  Preventative care coverage standards vary greatly amongst states