Elderly hospitalized patients treated by female
physicians are less likely to die within 30 days of
admission, or to be readmitted within 30 days of
discharge, than those cared for by male physicians,
according to a new study led by researchers at
Harvard T.H. Chan School of Public Health.
It is the first research to document differences in
how male and female physicians treat patients result
in different outcomes for hospitalized patients in
the U.S.
The researchers estimated that if male physicians
could achieve the same outcomes as their female
colleagues, there would be 32,000 fewer deaths each
year among Medicare patients alone—a number
comparable to the annual number of motor vehicle
accident deaths nationally.
The study was published online December 19, 2016 in
JAMA Internal Medicine.
“The difference in mortality rates surprised us,”
said lead author Yusuke Tsugawa, research associate
in the Department of Health Policy and Management.
“The gender of the physician appears to be
particularly significant for the sickest patients.
These findings indicate that potential differences
in practice patterns between male and female
physicians may have important clinical
implications.”
Previous studies have found differences in the way
female and male physicians practice—for example,
female physicians are more likely to adhere to
clinical guidelines and provide more
patient-centered communication—but this is the first
national study to look at whether the differences in
the way male and female physicians practice affect
clinical outcomes.
The researchers analyzed data from more than 1
million Medicare beneficiaries age 65 years or older
hospitalized with a medical condition and treated by
general internists between 2011 and 2014.
They adjusted for differences in patient and
physician characteristics, and considered whether
differences in patient outcomes varied by specific
condition or by severity of illness.
The researchers found that the patients, if treated
by a female physician, had a 4% lower relative risk
of dying prematurely and a 5% lower relative risk of
being readmitted to a hospital within 30 days.
The association was seen across a wide variety of
clinical conditions and variations in severity of
illness.
When the researchers restricted their analysis to
hospitalists—physicians focused on hospital care, to
whom patients are randomly assigned based on work
schedule—the results remained consistent, suggesting
that patient selection, in which healthier patients
might choose certain types of doctors, didn’t
explain the results.
Female physicians now account for approximately one
third of the U.S. physician workforce and comprise
half of all U.S. medical school graduates.
There are important gender differences in how women
physicians are treated—they are less likely to be
promoted and are generally paid less, said senior
author Ashish Jha, K.T. Li Professor of Health
Policy and director of the Harvard Global Health
Institute.
“There was ample evidence that male and female
physicians practice medicine differently. Our
findings suggest that those differences matter and
are important to patient health.
We need to understand why female physicians have
lower mortality so that all patients can have the
best possible outcomes, irrespective of the gender
of their physician,” said Jha.
Other Harvard Chan School authors included Jose
Figueroa, E. John Orav, and Daniel Blumenthal.
For more information
Comparison of Hospital Mortality and Readmission
Rates for Medicare Patients Treated by Male vs
Female Physicians
Link...
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