GENDER DIFFERENCES IN GENERAL-PRACTICE CONSULTATIONS - METHODOLOGICALCHALLENGES IN EPIDEMIOLOGIC RESEARCH

Background. Women consult their GP more often than men do. The distrib ution of complaints and diagnoses are different for women and men pati ents. Although several findings on gender differentials on mortality a nd health care consumption are rather consistent across studies, detai led findings and subsequent conclusions diverge in several important f ields. Objectives. Our aim was to explore methodological aspects of re search on gender differences in general practice. Methods. We reviewed empirical studies within this field, aiming to identify methodologica l and interpretative intricacies which deserve special attention in ep idemiological research on GP consultations. Results and Conclusions. W e found that descriptive and explanatory levels of research are freque ntly confused. Simple questions, answers and explanations are commonly raised for complex issues within a poorly defined theoretical explana tory framework. There is a need to assess relevant approaches for vari ous purposes, and to develop more uniform conceptual terms. Findings f rom one level are often transferred to another, incompatible level. Ep idemiological issues must be considered, especially matters related to denominator level and standardization/confounders-not in order to dec ide which level represents 'reality', but to clarify the consequences of different measures for different research questions. The contents o f the core variables and the potentials for bias should be discussed i n order to provide a sound basis for future explanatory studies.