Gender differences in healthcare utilization across Europe: Evidence from the European Health Interview Survey

BACKGROUND: Understanding gender-based disparities in healthcare utilization is crucial for informing equitable health policy. However, cross-national evidence across multiple service domains in Europe remains limited. OBJECTIVE: To examine gender differences in healthcare utilization across 27 European countries and explore variability across service types. METHODS: We analyzed data from 257,388 adults in the third wave of the European Health Interview Survey (2019-2020). Twelve healthcare utilization indicators were evaluated, including hospital admissions, outpatient care, mental health services, and medication use. Gender disparities were estimated using regression models with inverse probability weighting based on random forest propensity scores. RESULTS: Women had significantly higher odds of using nearly all outpatient and preventive services, including general practitioners, specialists, dental care, physiotherapy, psychotherapy, and home care. They also reported higher use of both prescribed and non-prescribed medications. No significant gender differences were observed in hospitalization rates. Sensitivity analyses adjusting for health needs confirmed these findings. Considerable heterogeneity emerged across countries and service domains: Latvia, Lithuania, and Poland showed the largest disparities (e.g., ORs 1.52-1.75 for recent specialist visits), while Denmark, the Netherlands, and Ireland displayed relatively small overall gaps but large differences for specific services, such as psychotherapy and home care. CONCLUSIONS: Women consistently utilize more non-acute healthcare services than men, while comparable hospitalization rates suggest differences in disease severity or care-seeking behaviors. The magnitude of these disparities varies considerably across European countries, highlighting the need for context-sensitive policies to address gender inequities in healthcare utilization.