Differences in leading causes of death, hospitalization and general practice visits among Dutch women and men.

Mortality differences between Dutch women and men were compared to differences in hospitalization and general practitioner visits. Ranks for the top fifteen diagnoses per sex as well as absolute and relative (to total of sex-specific diagnoses per group) sex ratio's were computed for the age groups 15-44 years, 45-64 years and over 65 years. To enhance comparability all procreative and contraceptive management data were excluded. Twice as many men compared to women die in all age groups, resulting in a surviving excess of women in the oldest age group (male/female ratio: 0.67). As expected from these mortality figures relatively more men than women are hospitalized, in particular in the oldest age group, 26.4 versus 19.5/100,000 (relative male/female ratio: 1.35). In a study population of twelve general practices, representative of the total Dutch population, more women sought medical care from the general practitioner than men and the individual women visited the general practitioner more frequently than men, resulting in a relative male/female ratio of 0.6 for general practice visits. Men visit the general practitioner for diseases for which they are also hospitalized and also often die from. Women visit the general practitioner for a wide range of ailments only in part representative of diseases for which they are hospitalized or die from. During aging, women tend to visit primary health care facilities more frequently for chronic, non-fatal disease, which can be explained partly by the absolute longer lifespan of women than men.