Table 4.

Association between Managed Care and Overall Problematic Health Care Experiences by Gender

	Any Problem				Number of Problems
	Women		Men		Women		Men
	OR	95% CI, Significance	OR	95% CI, Significance	OR	95% CI, Significance	OR	95% CI, Significance
Health plan managed care practices
Closed network of providers	1.4	[1.16 1.74]*** a	0.9	[0.72 1.27]	1.6	[1.34 1.91]*** a	1.0	[0.82 1.37]
Require selection of primary provider	0.6	[0.54 0.82]*** a	0.9	[0.69 1.21]	0.8	[0.70 1.00]* a	1.0	[0.83 1.39]
Gatekeeper requirements for referrals	1.4	[1.17 1.75]*** a	1.1	[0.86 1.52]	1.3	[1.14 1.61]***	1.1	[0.90 1.52]
Prior approval for treatment	1.2	[1.00 1.48]*	1.0	[0.79 1.37]	1.4	[1.20 1.69]***	1.4	[1.09 1.80]**
Managed care market characteristics
High HMO competition	0.9	[0.75 1.22]	0.8	[0.60 1.22]	0.9	[0.74 1.13]	1.0	[0.75 1.39]
Medicaid HMO competition	1.2	[1.03 1.62]* a	0.7	[0.52 0.97]*	1.3	[1.13 1.64]*** a	0.7	[0.56 0.99]*
High HMO penetration	1.6	[1.24 2.19]*** a	1.2	[0.84 1.84]	1.4	[1.12 1.81]** a	0.9	[0.68 1.37]
Medicaid HMO penetration	1.6	[1.27 2.07]***	1.2	[0.91 1.83]	1.4	[1.13 1.74]***	1.0	[0.77 1.43]
Managed care regulatory policies
Direct access to OB/GYN	1.3	[1.07 1.62]** a	0.7	[0.55 1.03]	1.1	[0.97 1.38] a	0.8	[0.61 1.08]
Specialist as primary care provider	0.9	[0.75 1.08] a	1.4	[1.08 1.82]**	1.0	[0.85 1.17] a	1.3	[1.07 1.70]**

Odds ratios from logistic regression models weighted to the sample population. All models control for respondent demographic and socioeconomic characteristics, health status, insurance characteristics, and geographic region.

Reference group for managed care market characteristics are low HMO competition and low HMO penetration.

Significance:

^*p<.05;

^**p<.01;

^***p<.001.

a—significant difference between women and men, linear hypothesis testing χ²; p<.05.