Little is known about whether the effects of physician sex on patients´ clinical outcomes vary by patient sex.
Aim:
To examine whether the association between physician sex and hospital outcomes varied between male and female patients hospitalized with medical conditions.
Design:
Retrospective observational study.
Setting:
Medicare claims data.
Patients:
Random sample of 20% of Medicare fee-for-service beneficiaries hospitalized with medical conditions during 2016 to 2019 and treated by hospitalists.
Measurements:
The primary outcomes were 30-day patient mortality and readmission rates, adjusted for patient and physician characteristics and hospital-level exposure averages (effectively comparing physicians within the same hospital).
Results:
Of 458,108 female and 318,819 male patients, 142,465 (31.1%) and 97,500 (30.6%) were treated by female physicians, respectively.
Both male and female patients had lower mortality when treated by female physicians; However, the benefit of receiving care from female physicians was greater for female patients than for male patients (difference in differences, −0.16 percentage points [pp] [95% CI, −0.42 to 0.10 pp]). .
For female patients, the difference between male and female physicians was large and clinically significant (adjusted mortality rates, 8.15% vs. 8.38%; average marginal effect [AME], −0.24 pp [CI, −0 .41 to −0.07 pp]).
For male patients, a significant difference between female and male physicians could be ruled out (10.15% vs. 10.23%; AME, −0.08 pp [CI, −0.29 to 0.14 pp]). The pattern was similar for patient readmission rates.
Limitation:
The findings may not be generalizable to younger populations.
Conclusion:
The findings indicate that patients have lower mortality and readmission rates when treated by female physicians, and the benefit of receiving treatments from female physicians is greater for female patients than for male patients.
Treatment provided by female physicians reduces mortality and hospital readmission rates
Patients have lower rates of mortality and hospital readmissions when treated by female doctors, and female patients benefit more than their male counterparts, new research suggests.
The mortality rate for female patients was 8.15% when they were treated by female doctors versus 8.38% when the doctor was male, a clinically significant difference, the researchers found. While the difference for male patients was smaller, female doctors still had the advantage with a 10.15% mortality rate compared to the 10.23% rate for male doctors.
The researchers found the same pattern in hospital readmission rates.
The study is published in the peer-reviewed journal Annals of Internal Medicine .
Patient outcomes should not differ between male and female doctors if they practice medicine the same way, said Dr. Yusuke Tsugawa, resident associate professor of medicine in the College´s general internal medicine and health services research division. of Medicine David Geffen. at UCLA and lead author of the study.
"What our findings indicate is that male and female physicians practice medicine differently, and these differences have a significant impact on patients´ health outcomes ," Tsugawa said. "Further research into the underlying mechanisms that link physician gender to patient outcomes, and why the benefit of receiving female treatment is greater for female patients, has the potential to improve patient outcomes in all areas".
Researchers examined Medicare claims data from 2016 to 2019 for approximately 458,100 female and nearly 319,800 male patients. Of them, 142,500 and 97,500, or approximately 31% of both, were treated by female doctors. The primary outcomes were 30-day mortality from the date of hospital admission and 30-day readmission from the date of discharge.
The researchers write that there may be several factors driving these differences. They suggest that male doctors may underestimate the severity of their patients´ illness; Previous research has noted that doctors underestimate their patients´ pain levels, gastrointestinal and cardiovascular symptoms, and stroke risk, which could lead to delayed or incomplete care. Additionally, female doctors can communicate better with their patients, making these patients more likely to provide important information that leads to better diagnoses and treatments. Finally, patients may feel more comfortable receiving sensitive tests and engaging in detailed conversations with physicians.
But more research is needed on how and why male and female doctors practice medicine differently and its impact on patient care, Tsugawa said. "A better understanding of this issue could lead to the development of interventions that effectively improve patient care," she said.
In addition, gender differences in doctors´ remuneration must be eliminated, he said. "It is important to note that female physicians provide high-quality care, and therefore having more female physicians benefits patients from a social standpoint," Tsugawa said.
Co-authors of the study are Dr. Atsushi Miyawaki of the University of Tokyo, Dr. Anupam Jena of Harvard University, and Dr. Lisa Rotenstein of UC San Francisco.
