Quality in Primary Care Open Access

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Gender makes the difference: the influence of patients�?¢�?�?��?�?� gender on the delivery of preventive services in primary care in Poland

Ewelina Gowin, Dirk Avonts, Wanda Horst-Sikorska, Magdalena Ignaszak-Szczepaniak, Michal Michalak

Objective General practitioners’ (GPs’) time and resources for preventive services needs to be delivered equitably. We aimed to study the effect of patients’ gender on the delivery of preventive procedures to adult patients aged 40 years and over. Method An observational study was performed in primary care surgeries in Wielkopolska (Poland) as a part of the Improving Quality in Primary Care (PIUPOZ) programme carried out by Family Medicine Department of the University of Medical Sciences, Poznan. Trained observers directly observed GPs in their office, to register preventive procedures performed during the consultation and in the previous year (via the medical record) in patients aged 40 years and over. Results A total of 1073 preventive procedures were registered among 450 patients (267 women and 183 men) by 113 doctors in one year. The most common were serum glucose, blood pressure and total cholesterol measurements. Six procedures were offered to less than 10% of patients: dietary advice, tobacco use and alcohol screening, exercise counselling, body mass index (BMI) recording, and waist measurement. Men were more likely to receive tobacco use and alcohol screening and BMI measurement, while more women were offered a total cholesterol screen. Conclusions The annual delivery rate of preventive procedures in patients aged 40 years and above is below the recommended level set by the Polish Ministry of Health. Procedures based on clinical examinations or laboratory tests were offered and performed more frequently than lifestyle advice. More men than women received preventive services for tobacco use or alcohol screening and BMI measurements. Patients’ gender and physicians’ engagement may influence GPs’ preventive attitude and performance. These elements should be incorporated in the development of guidelines concerning prevention in primary care.