here. - Canadian Women's Health Network

More documents

Recommendations

Info

Women, Income andHealth in Manitoba62that women are supposed to havegreater concerns about their bodiesbecause they undergo menstruation,childbirth and the menopause, whilemen are conditioned by society to bestrong and stoical. ‘It is an attitude thatpermeates the health service thoughthere is no evidence to support it,’added Macintyre. Indeed, it pointsthe other way.’The assumption that men are stoicalcan also have serious consequencesas researchers on both sides of theAtlantic have revealed. In one recentUS study, male and female actorsperformed realistic scripts in whichthey played the parts of patientssuffering from chest pains andshortness of breath. They were thenexamined by a group of 192 doctorswho were asked to describe what theywould do for their patients in similarcircumstances. The results werestriking. The doctors plumped for twomain diagnoses: either the patient hada severe cardiac problem or a psychosomaticcondition in which emotionaldisturbance, not physical illness, wasthe cause. Their choice had a greatdeal to do with the gender of theactors. ‘When confronted with thesame presenting symptoms, vitalsigns, and test results depictedin a professionally acted way,physicians were much less likelyto arrive at a cardiac diagnosis inwomen, treat women medically,believe treatments were necessaryor to make health education andlifestyle change recommendationssuch as quitting smoking,’ state theresearchers from the New EnglandResearch Institute in Boston. Bycontrast, the doctors were morelikely to rate women ‘patients’ assuffering from emotional problemsand to suggest psychiatrictreatment. In other words, ifyou complain of chest pains, youget intense cardiac care – if youare a man. If you are a woman,you could end up undergoingpsychiatric treatment.‘Women aren’t supposed to complainof heart disease and so doctors areless prepared to accept that they haveit,’ said Macintyre. ‘We make allsorts of assumptions, based onunsupported stereotypes – forinstance, that men are silent stoicswhile women are whingers – but donot test them out before we act onthem. We have got to change thatkind of thinking.’ 96 (emphasis added)
APPENDIX 3:HEALTH SERVICE UTILIZATION BYMANITOBA WOMEN – EXPENDITUREBY INCOME QUINTILEWomen, Income andHealth in Manitoba63(The following description was preparedby Dr. Patricia Kaufert, Department ofCommunity Health Sciences, Facultyof Medicine, University of Manitoba)The Manitoba Health Services InsurancePlan (MHSIP) provides insurance coverageto all Canadian citizens and landedimmigrants who qualify as residents of theProvince. Coverage includes entitlementto a comprehensive range of health careservices including acute hospital care andphysician services without fees, premiumsor co-payment charges. The administrativesystem developed to run this insurancesystem has created a computerized recordof health service utilization by a completepopulation of over a million people.Extensively used in research, the reliability,concurrent validity and predictive validityof these data are now well established(Roos et al. 1987; Roos et al. 1988;Muhajarine et al. 1997).This analysis is based on three of the filescreated as part of this system; they are theRegistry file, the Physician Claims file andthe Hospital-Separation Abstract file. TheRegistry file includes information on theage and sex of every individual entitled tocoverage (virtually the entire population ofManitoba), their address and a uniqueidentifier number assigned to them byMHSIP as their Manitoba Health (MH)number. The date when an individual firstregistered with MHSIP is also entered intothe file and, if they leave the province ordie, the date when their coveragewas cancelled.A second file, the Physician Claims file, isthe product of the system of payment tophysicians. The majority of physicians inManitoba are paid on a fee-for-servicesystem with MHSIP as the unique payer.To be eligible for payment, physicians mustsubmit detailed claims cards which includetheir own code and specialty, the patient’sMH insurance number, the type of serviceprovided (tariff), the reason for the visit(diagnosis) and the date of the service.Regardless of the number of other reasonsinvolved, only the diagnosis identified bythe physician as most responsible for thevisit is entered into the file. Diagnosesare coded using the first 3 digits of theInternational Classification of Disease, 9threvision, Clinical Modification (ICD-9-CM)diagnostic codes. The Physician Claims fileincludes all claims for ambulatory care andfor care provided by physicians in hospitalon either an in-patient or outpatient basis.The few physicians who are on salarysubmit ‘dummy’ claims cards. Claimssubmitted for diagnostic imagining andlaboratory tests carried out in privatelyowned facilities are assigned a tariff codeand entered into the Physicians Claims file.Manitoba Health documents all hospitalutilization through detailed separationabstracts submitted by the province’shospitals for every patient they discharge.These abstracts include the patient’s MHnumber, the identification numbers of theattending physician(s), and up to 16 fieldsof diagnostic and procedure codes. Theseare coded using the 5-digit ICD-9-CMdiagnostic and 4-digit procedure codes.GENDER-SPECIFIC CONDITIONSWe selected all the diagnoses andprocedures specific to either women (suchas obstetric care) or men (such as testicularcancer) from the Physician Claim Fileand the Hospital Separation Abstract Fileand constructed the following categories:
Page 1 and 2:
WOMEN, INCOME ANDHEALTH IN MANITOBA
Page 3 and 4:
TABLE OF CONTENTSPageA. EXECUTIVE S
Page 5 and 6:
EXECUTIVE SUMMARYTHE LINK between p
Page 7 and 8:
Women, Income andHealth in Manitoba
Page 9 and 10:
B. INTRODUCTIONMuch work has been d
Page 11 and 12: Consistent with the majority of soc
Page 13 and 14: Health and Well-Being of Children i
Page 15 and 16: Women, Income andHealth in Manitoba
Page 17 and 18: members of different visible minori
Page 21 and 22: 3. How has the connection between i
Page 23 and 24: E. INCOME AND THE HEALTH OF WOMEN -
Page 27 and 28: majority of British households,rega
Page 31 and 32: The following chart, based on a cha
Page 33 and 34: marsh potatoes, berries, etc. As a
Page 35 and 36: opportunities for women may beone o
Page 37 and 38: 2. Manitoba Data - Income and Healt
Page 39 and 40: CHART 3HEALTH CARE EXPENDITURES ON
Page 41 and 42: 3. What Does This Mean?As in other
Page 43 and 44: procedures. It is noteworthy that t
Page 45 and 46: 2. The Commonwealth Secretariat -Mo
Page 49 and 50: H. MAKING PUBLIC POLICY HEALTHIER F
Page 51 and 52: against women and its consequences
Page 53 and 54: 3.3 CHILD TAX BENEFITThe Government
Page 55 and 56: Household Basic Rent Rent Including
Page 57 and 58: If RHAs are open to suchcollaborati
Page 59 and 60: APPENDIX 1:SUGGESTIONS FOR FUTURE R
Page 61: Women, Income andHealth in Manitoba
Page 65 and 66: APPENDIX 4:INTERVIEWS WITH ABORIGIN
Page 73 and 74: ELEMENT #11GENDER SENSITIVE TRAININ
Page 77 and 78: ENDNOTES1. Sarlo, Christopher, “P
Page 79 and 80: ENDNOTES (continued)45. Arber, Sara
Page 81 and 82: ENDNOTES (continued)88. Mustard, Ca
Page 83 and 84: REFERENCES (continued)Clarke, H.F.
Page 85 and 86: REFERENCES (continued)Macintyre, Sa
Page 87 and 88: REFERENCES (continued)Vancouver/Ric
show all

here. - Canadian Women's Health Network

Create successful ePaper yourself

Delete template?

Save as template?