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      Gender differences in care-seeking behavior and healthcare consumption immediately after whiplash trauma

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          Abstract

          Objective

          The aim was to study gender differences in care-seeking behavior and treatment provided immediately after whiplash trauma.

          Methods

          Participants were residents from a defined geographical area, Skaraborg County in the southwestern part of Sweden. A cohort of 3,368 persons exposed to whiplash trauma and attending a healthcare facility immediately after the trauma between 1999 and 2008 were identified in a database. Information about gender, age, time elapsed prior to seeking care, type of healthcare contact, initial treatment provided and eventual hospitalization time was retrieved.

          Results

          Women sought care later than men (p = 0.00074). Women consulted primary healthcare first more often than men, who more often first sought hospital care (p = 0.0060). There were no gender differences regarding the type of treatment after trauma. Women had longer hospital admission than men (p = 0.022), indicating their injuries were at least similar to or worse than men’s.

          Conclusion

          Women sought healthcare later than men after whiplash trauma. Although not directly investigated in this study, it raises the question if this may reduce their probability of getting financial compensation compared to men.

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          Most cited references31

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          Statistical estimates and transformed beta-variables

          G BLOM, G Blom, Blom (1958)
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            "The Laundry Bag Project"--unequal distribution of dermatological healthcare resources for male and female psoriatic patients in Sweden.

            Psoriasis and eczema are common dermatological diseases that occur with approximately equal frequency in men and in women. The aim of this study was to determine whether men and women with dermatological diseases in need of ultra-violet radiation (UV) treatment receive equal care. We conducted a retrospective analysis of records of all patients referred to and seen at our clinic during 2003 with diagnoses of psoriasis or eczema. We performed a gender-based analysis of the number, type, and estimated cost of the treatments given to each patient. We evaluated similar data from a Swedish Psoriasis Association (SPA) treatment center and from the state pharmacy monopoly (Apoteksstatistiken). Men with eczema or psoriasis received more help with emollients than did women and were given a greater number of UV treatments. At our clinic and at the SPA center, women constituted 37 and 42%, respectively, of the individuals who received UV treatment; yet, they received only 34 and 36% of the treatments, respectively. Women were prescribed self-care more often than men, with 61% of prescriptions for emollients and 48% of specific topical treatments for psoriasis dispensed to women. We discovered previously unrecognized gender differences in standard dermatological treatment for common diagnoses at our hospital. To ensure optimal care for each patient, treatment disparity should be recognized and gender-based analyzes be carried out when planning dermatological health care.
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              The incidence of whiplash trauma and the effects of different factors on recovery.

              We performed a prospective study of patients with a whiplash trauma to the cervical spine to describe the incidence of these injuries and to evaluate prognostic factors for disability and recovery. A total of 356 patients were enrolled in the study. All the patients received a comprehensive questionnaire after the injury, and 296 cases responded to the follow-up protocol more than 1 year after the accident. Disability related to the whiplash trauma was used as the outcome variable for the assessment of prognostic factors. The annual incidence of acute whiplash trauma in the catchment area was 4.2 per 1,000 inhabitants and 3.2 per 1,000 for whiplash-associated disorder grades 1-3. Thirty-two percent reported persisting disability at follow-up. The following factors were significantly associated with a poor prognosis: pretraumatic neck pain, low educational level, female gender, and whiplash-associated disorder grades 2-3.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                25 April 2017
                2017
                : 12
                : 4
                : e0176328
                Affiliations
                [1 ]Hälsan & Arbetslivet, Occupational Health Care Unit, Region Västra Götaland, Gothenburg, Sweden
                [2 ]Department of Public Health and Community Medicine Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
                [3 ]Research and Development Center Södra Älvsborg Närhälsan, Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
                [4 ]Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Unit of Physiotherapy, University of Gothenburg, Gothenburg, Sweden
                [5 ]Institute of Clinical Neuroscience—Rehabilitation Medicine, University of Gothenburg, Gothenburg, Sweden
                [6 ]Cairns Clinical School, College of Medicine and Dentistry, James Cook University, Cairns, Australia
                Johns Hopkins University Bloomberg School of Public Health, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                • Conceptualization: AT RG.

                • Data curation: AT RG LN.

                • Formal analysis: AT RG LN KS.

                • Funding acquisition: AT.

                • Investigation: AT RG.

                • Methodology: RG AT.

                • Project administration: AT RG.

                • Resources: AT.

                • Software: AT LN.

                • Supervision: RG KS LN.

                • Validation: RG LN.

                • Visualization: AT RG LN.

                • Writing – original draft: AT RG.

                • Writing – review & editing: AT RG LN KS.

                Article
                PONE-D-15-48745
                10.1371/journal.pone.0176328
                5404839
                28441465
                39c092c5-3ab1-462a-a45a-58da8d47096c
                © 2017 Tenenbaum et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 7 November 2015
                : 9 April 2017
                Page count
                Figures: 0, Tables: 4, Pages: 9
                Funding
                The authors received no specific funding for this work.
                Categories
                Research Article
                Medicine and Health Sciences
                Critical Care and Emergency Medicine
                Trauma Medicine
                Traumatic Injury
                Engineering and Technology
                Management Engineering
                Risk Management
                Insurance
                Medicine and Health Sciences
                Health Care
                Health Care Facilities
                People and Places
                Geographical Locations
                Europe
                Sweden
                Medicine and Health Sciences
                Public and Occupational Health
                Traumatic Injury Risk Factors
                Road Traffic Collisions
                Biology and Life Sciences
                Behavior
                Medicine and Health Sciences
                Health Care
                Health Care Facilities
                Hospitals
                Research and Analysis Methods
                Mathematical and Statistical Techniques
                Statistical Methods
                Regression Analysis
                Linear Regression Analysis
                Physical Sciences
                Mathematics
                Statistics (Mathematics)
                Statistical Methods
                Regression Analysis
                Linear Regression Analysis
                Custom metadata
                According to the Swedish ethics framework http://www.epn.se/en/start/regulations/ permission is only allowed for using data for any statistical analysis specified in the ethics application submitted by the researchers mentioned in the ethics application. Our current approval does not cover publication of individual data even if deidentified. Violating this is an offence according to Swedish law. Due to restrictions imposed by The Regional Ethical Review Board of Gothenburg, Sweden, the data are available upon request. For more information about data from the this study please contacted the authors (e-mail: artur.tenenbaum@ 123456vgregion.se ).

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