Patients of women physicians experience lower mortality, readmission rates
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Key takeaways:
- Female and male patients experienced lower mortality rates when treated by female vs. male physicians.
- Female patients experienced better benefit of receiving care from female physicians.
Both male and female patients experienced lower mortality and readmission rates when treated by female physicians, according to study results published in Annals of Internal Medicine.
Researchers additionally reported a larger benefit of receiving treatment from female physicians among female patients vs. male patients.
Impetus
“Prior research has demonstrated better outcomes by female physicians in some circumstances, including hospital and surgical outcomes,” Lisa Rotenstein, MD, MBA, MSc, assistant professor and medical director at University of California at San Francisco, and director of the Physicians Foundation Center for Physician Experience and Practice Excellence, told Healio. “Given evidence of differential care patterns for women patients and concerns that their symptoms or experiences are not always taken seriously, we wanted to understand how the relationship between physician sex and hospital outcomes varies depending on the patient being cared for by each physician.”
The retrospective observational study included Medicare claims data for 458,108 female patients and 318,819 male patients hospitalized with medical conditions between 2016 and 2019, and treated by hospitalists.
Patients’ 30-day mortality and readmission rates adjusted for patient and physician characteristics and hospital-level averages of exposures served as primary outcomes.
Differential care
Overall, women physicians treated 31.1% of female patients and 30.6% of male patients.
Results showed female and male patients experienced lower mortality rates when treated by female physicians.
Of note, compared with male patients, female patients experienced better benefit of receiving care from female physicians (difference-in-differences per patient, ‒0.16 percentage points; 95% CI, ‒0.42 to 0.1). Researchers found adjusted mortality rates for female patients treated by female physicians of 8.15% and 8.38% among those treated by male physicians (average marginal effect, ‒0.24 percentage points; 95% CI, ‒0.41 to ‒0.07).
Researchers observed unadjusted 30-day readmission rates of 15.83% overall, 15.23% among female patients and 16.71% among male patients. Additionally, results showed that both female and male patients experienced lower adjusted readmission rates when treated by a female physician. Researchers observed readmission rates of 15.51% among female patients treated by female physicians compared with 16.01% among female patients treated by male physicians.
“We want excellent care outcomes for all patients, and this study highlights that both male and female patients experienced lower mortality when treated by female physicians,” Rotenstein said. “Our findings underscore an opportunity to better understand the mechanisms by which these better outcomes occur so that we can encourage those patterns of care across physicians.”
In addition, data indicate that female patients experience different experiences of care and receive different treatment vs. male patients, she added.
“Women are more likely to be misdiagnosed while having a heart attack, often wait longer in the ER before receiving pain relief for abdominal pain, and are less likely to receive pain medication after coronary bypass surgery,” Rotenstein said. “Our primary findings, which are focused on the objective outcomes of mortality and readmission, demonstrated a significant, favorable difference in these measures when women patients are treated by women physicians.”
Researchers reported a limitation of the study, including the fact that the findings may not be generalizable to younger patients.
Additional research
Further research needs include the need to identify the exact mechanisms by which improved outcomes for patients treated by female doctors occur, according to Rotenstein.
“This includes identifying whether outcomes are due to female physicians spending more time with patients or to more patient-centered communication and whether female physicians respond to the needs and symptoms of female patients differently,” she said.
The next step in research is to understand how current incentive systems influence these behaviors, Rotenstein continued.
“The predominant fee-for-service payment system provides incentives for quantity of care, and amidst high demand, health care workers may be pressured to enhance patient throughput,” she said. “Further study will be needed to understand which incentive systems lead to the patterns of care delivery exhibited by women physicians that ultimately result in favorable mortality and readmission outcomes.”
For more information:
Lisa Rotenstein, MD, MBA, MSc, can be reached at lisa.rotenstein@ucsf.edu.
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