More Women are Medicated While More Men are Talked Out: Persistent Gender Disparities in Mental Health Care

Abstract

Introduction

Physician incentives have been shown in previous studies to help reduce socioeconomic disparities in health care. Its impact on gender disparities, however, has rarely been investigated.

Aim

The impact of physician incentives on gender disparities in mental health care was investigated in this retrospective study.

Method

De-identified health administrative data from physician claims, hospital separations, vital statistics, prescription database, and insurance plan registries were linked and examined. Monthly cohorts of individuals with depression who were residing in British Columbia, Canada were identified and their use of mental health services tracked for 12 months following receipt of initial diagnosis. indicators that assess receipt of the following services were created:

– counseling/psychotherapy (CP);

– minimally adequate counseling/psychotherapy (MACP);

– antidepressant therapy (AT);

– minimally adequate antidepressant therapy (MAAT).

interrupted time series analysis was used to estimate changes in these indicators before (01/2005–12/2007) and after (01/2008–12/2012) physician incentives were introduced.

Results

At the beginning of the study period, the percentage of individuals diagnosed with depression who received counseling/psychotherapy was higher, on average, among men (CP: 58.4%, MACP: 13.6%) than women (CP: 57.1%, MACP: 10.9%). in contrast, the percentage who received antidepressant therapy was higher among women (AT: 57.7%, MAAT: 47.4%) than men (AT: 53.6%, MAAT: 41.9%). Levels for these indicators have changed over time but the statistically significant differences between men and women were virtually the same before and after incentives were introduced.

Conclusions

Gender disparities in mental health care persist despite the introduction of physician incentives designed to enhance access to mental health services in primary care.

Disclosure of interest

The authors have not supplied their declaration of competing interest.