Abstract:
BACKGROUND:Depression is more prevalent among women and people with low socio-economic status. Uncertainties exist about how general practitioner (GP) depression care varies with patients' social position. OBJECTIVE:To investigate associations between patients' gender and educational status combined and GP depression care following certification of sickness absence. METHODS:Nationwide registry-based cohort study, Norway, 2012-14. Reimbursement claims data from all consultations in general practice for depression were linked with information on socio-demographic data, social security benefits and depression medication. The study population comprised all individuals aged 25-66 years with taxable income, sick-listed with a new depression diagnosis in general practice in 2013 (n = 8857). We defined six intersectional groups by combining educational level and gender. The outcome was type of GP depression care during sick leave: follow-up consultation(s), talking therapy, medication and referral to secondary care. Associations between intersectional groups and outcome were estimated using generalized linear models. RESULTS:Among long-term absentees (17 days or more), highly educated women were less likely to receive medication compared to all other patient groups [relative risk (RR) ranging from 1.17 (95% confidence interval 1.03-1.33) to 1.49 (1.29-1.72)] and more likely to receive talking therapy than women with medium [RR = 0.90 (0.84-0.98)] or low [RR = 0.91 (0.85-0.98)] education. CONCLUSIONS:Our findings suggest that GPs provide equitable depression care regarding consultations and referrals for all intersectional groups but differential drug treatment and talking therapy for highly educated women. GPs need to be aware of these variations to provide personalized care and to prevent reproducing inequity.
journal_name
Fam Practjournal_title
Family practiceauthors
Riiser S,Haukenes I,Baste V,Smith-Sivertsen T,Hetlevik Ø,Ruths Sdoi
10.1093/fampra/cmaa120subject
Has Abstractpub_date
2020-11-05 00:00:00eissn
0263-2136issn
1460-2229pii
5957193pub_type
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