A study published online in JAMA Internal Medicine on December 19, 2016 entitled, “Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians” found that patients who were treated by female physicians had significantly lower mortality rates (11.07% versus 11.49%) and significantly lower readmission rates (15.02% versus 15.57%) when compared with patients who were treated by male physicians within the same hospital.
Prior studies have found evidence that men and women may practice medicine differently (i.e., differences in practice patterns and process measures of quality): female physicians may be more likely to adhere to clinical guidelines, female physicians may provide preventative care more often, they may use more patient-oriented communication, they may perform as well or better on standardized examinations, and female physicians provide more psychosocial counseling to their patients than male physicians.
There is evidence that female physicians, who account for one-half of all medical school graduates and approximately one-third of the working physicians in the United States, may provide a higher level of care than male physicians.
The recent study analyzed patient 30-day mortality rates and readmission rates for hospitalists and analyzed a twenty-percent random sample of Medicare fee-for-service beneficiaries who were 65 and older and were hospitalized with a medical condition and were treated by general internists between January 1, 2011 and December 31, 2014. The researchers examined a total of 1,583,028 hospitalizations for their 30-day morality analysis (the median age of the patients was 80.2; there were 621,412 male patients and 961,616 female patients). The researchers examined a total of 1,540,797 hospitalizations for their readmission analysis (the median age of the patients was 80.1; there were 602,115 male patients and 938,682 female patients).
The study involved 58,344 general internists who treated at least one Medicare beneficiary who was hospitalized with a medical condition. Of those physicians, 32.1% (18,751) were female. The female physicians were younger than the male physicians (42.8 versus 47.8), they were more likely to have undergone osteopathic training (1,577 (8.4%) versus 2,770 (7.0%)), and they treated fewer patients than the male physicians (131.9 hospitalizations versus 180.5 hospitalizations for the male physicians).
The study found that the patient characteristics were similar for patients treated by female physicians versus male physicians, except that female physicians treated slightly higher proportions of female patients. The study found that female physicians were more likely to work in large, nonprofit, and major teaching hospitals located in the Northeast region of the United States when compared to male physicians.
The researchers found that the differences for those treated by female physicians versus male physicians persisted across eight common medical conditions and across the severity of the patients’ illnesses.
The researchers stated, ” … given that there are more than 10 million Medicare hospitalizations due to medical conditions in the United States annually and assuming that the association between sex and mortality is causal, we estimate that approximately 32 000 fewer patients would die if male physicians could achieve the same outcomes as female physicians every year. The effect would be even larger if the associations between physician sex and patient outcomes also hold for non-Medicare populations.” (emphasis added)
The study concluded, “Elderly hospitalized patients treated by female internists have lower mortality and readmissions compared with those cared for by male internists. These findings suggest that the differences in practice patterns between male and female physicians, as suggested in previous studies, may have important clinical implications for patient outcomes.”
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