Add StudioX as a preferred source on GoogleA large study of hospitalized patients in Ontario has found an association between being treated by a female physician and a lower risk of dying within 30 days, according to a report by Ynetnews. The researchers say the reason for the gap is still unknown.
The study was published October 30 in JAMA Network Open. It examined records for 958,150 adults hospitalized in Ontario between 2008 and 2022. Their median age was 74.
What the researchers found
Patients were admitted for one of seven common conditions: heart attack, heart failure, atrial fibrillation, chronic obstructive pulmonary disease (COPD), pneumonia, stroke or gastrointestinal bleeding.
The study included 15,165 physicians, about 36% of them women. Female doctors were primarily responsible for roughly 27% of the patients. The primary physician was defined as the doctor who cared for a patient for the most days during the hospital stay.
After adjusting for differences among patients, physicians and hospitals, the 30-day mortality rate was 12.3% for patients mainly treated by female physicians and 13.7% for those treated by male physicians. That is a gap of 1.4 percentage points, or 12% lower odds of death within 30 days.
The pattern held when researchers looked at the share of hospital days under a female doctor’s care. Each 10-percentage-point increase was linked to 7% lower odds of death within 30 days.
- The association appeared for both men and women, but was larger among women: 1.29 percentage points, compared with 0.75 for men.
- It appeared in six of the seven conditions. Atrial fibrillation was the exception.
- Female physicians in the study were generally younger, had less experience and treated fewer patients each year. Their patients tended to be older and more frail.
The researchers accounted for those differences, along with underlying medical conditions, socioeconomic status and prior use of health care services.
Possible explanations, and mixed results over time
The study did not directly examine how doctors made decisions or spoke with patients. Drawing on earlier research, the investigators suggested possible explanations, including the time doctors spend with patients, involving patients in decisions, following treatment guidelines and consulting colleagues.
Prof. Anat Gafter-Gvili, head of Internal Medicine Department A at Beilinson Hospital in Israel, commented on the findings to Ynetnews. She said that from her experience, female physicians invest heavily in communicating with patients, and that giving patients time to speak can produce a fuller medical history and better-chosen tests. She also said female physicians are not afraid to consult colleagues.
The lower mortality was also seen at 90 days and one year, though the differences shrank over time. Results on readmissions were less consistent. The 30-day readmission rate was 18.6% for patients of female physicians and 18.9% for those of male physicians. There was no statistically significant difference at 90 days, and at one year care by a female physician was linked to slightly higher odds of readmission. Care by female physicians was also associated with longer hospital stays.
Limits of the research
The researchers emphasized that this was an observational study. It identified an association but cannot show that a doctor’s sex caused the differences in outcomes.
Hospital care is delivered by entire medical teams, and the researchers could not fully account for every professional involved. They also could not directly examine treatment methods or clinical decision-making. The findings cannot be applied to outpatient care because only hospitalized patients were studied.
The researchers called for more studies to determine what explains the differences and whether particular approaches to patient care could improve outcomes.
Source: Ynetnews
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