Physician Gender Unrelated to Patient Mortality

Joe Barber Jr, PhD

March 14, 2013

A physician's gender does not appear to have an effect on patients' healthcare use and mortality, according to the findings of a prospective observational study.

Anthony Jerant, MD, from the Department of Family and Community Medicine, Center for Healthcare Policy and Research, University of California Davis School of Medicine, Sacramento, and colleagues published their findings in the March-April issue of the Journal of the American Board of Family Medicine.

The authors note that previous findings revealed differences in practice style associated with physician gender that may affect patient outcome and healthcare use. "For example, female physicians consistently have been found to employ a more patient-centered communication style, devoting more time to elements such as psychosocial counseling, social exchange, pursuing active partnership, and providing encouragement and reassurance," the authors write. "Other studies have found that female physicians are more likely than men to provide certain morbidity- and mortality-reducing preventive services to women (eg, Papanicolaou testing, mammography)."

In the study, the authors analyzed the association of the gender of the usual source of healthcare during 1 year with several healthcare use outcomes during the following year, including total healthcare expenditures, prescription drug expenditures, and number of office visits. They analyzed data from the prospective 2002 to 2008 United States Medical Expenditure Panel Surveys for adults 18 years of age or older, who reported a usual provider, and who participated in the survey for 2 years.

Among the 21,365 participants included in the analyses, provider characteristics, including gender (adjusted hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.64 - 1.38; P = .76) and ethnicity (non-Hispanic white, adjusted HR, 0.86; 95% CI, 0.61 - 1.21; P = .39), were not associated with all-cause mortality.

The authors also performed regression analysis using several variables, including age, gender, ethnicity, and household income, as covariates. They found no associations between healthcare provider gender and total healthcare expenditures (adjusted parameter estimate [PE], 4.56%; 95% CI, −3.04 to 12.76; P = .25), prescription expenditures (adjusted PE, 3.33%; 95% CI, −4.32 to 11.59), office visits (adjusted PE, 1.28%; 95% CI, −3.30 - 6.08), emergency department use (adjusted odds ratio [AOR], 0.98; 95% CI, 0.87 - 1.11), and hospital use (AOR, 0.98; 95% CI, 0.87 - 1.11).

Patients with a female healthcare provider were more likely to be younger (AOR, 0.90; 95% CI, 0.87 - 0.93; P < .001), female (AOR, 2.48; 95% CI, 2.28 - 2.70; P < .001), and living in an urban area (AOR, 1.43; 95% CI, 1.23 - 1.66; P < .001). The limitations of the study included potential misreporting by the respondents, a lack of information on certain healthcare provider characteristics, and survey nonresponse.

"In adjusted analyses of prospective data from a large U.S. sample, the gender of the [usual source of care] was not associated with measures of health care use (total and prescription drug expenditures, emergency department and hospital use, office visits) or mortality," the authors write. "These findings suggest that [usual source of care] gender may not have important effects on health care use and mortality at a national level."

The authors have disclosed no relevant financial relationships.

J Am Board Fam Med. 2013;26:138-148. Abstract

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