Study suggests that women treated by doctors have a lower risk of death and hospital readmission

The benefit of receiving care from a female doctor was greater for female patients than for male patients. The research was conducted by scientists from US universities (Harvard and University of California) and the University of Tokyo, Japan.

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Brazil
HEALTH-STUDY
4 hours ago
BY Folhapress

THAIS PORSCHCURITIBA, PR (FOLHAPRESS) – A study that used a sample of more than 700,000 Medicare patients – the health insurance system managed by the United States government – aged 65 or over who were hospitalized between 2016 and 2019 and treated by hospitalists, found that both female and male patients had lower rates of mortality and readmission when treated by female doctors.

The benefit of receiving care from a female doctor was greater for female patients than for male patients. The research was conducted by scientists from US universities (Harvard and University of California) and the University of Tokyo, Japan.

Although the differences in patient mortality and readmission between male and female physicians were modest, the 0.24 percentage point difference in mortality and the 0.48 percentage point difference in readmission correspond to 1 death in every 417 Medicare hospitalizations and 1 readmission for every 208 hospitalizations, which are arguably significant differences considering there are more than 4 million Medicare hospitalizations per year for a medical condition in the United States.

Despite the small discrepancy, Fabio Fernandes Neves, superintendent of the UFSCar University Hospital (HU-UFSCar/Ebserh) and specialists in Hospital Management and Health Systems, states that the findings have their value. “It is important to differentiate the statistical significance from the clinical one. The difference is small, but when we talk about the individual it makes all the difference.”

The study also shows sex differences in reported patterns of pain, gastrointestinal symptoms and cardiovascular symptoms, with healthcare professionals – particularly men – tending to underestimate such symptoms when experienced by women. Another survey, from 2019, already revealed that doctors were more likely than their female counterparts to underestimate the risks of stroke in women, for example.

As a result, underappreciation of symptoms and risks among female patients can result in delayed or incomplete care, ultimately leading to worse patient outcomes.

In Neves’ view, doctors have more communication and empathy skills, placing themselves more easily in the patient’s and family’s position. This facilitates dialogue and patients leave the hospital better advised to adhere more to treatment.

“Another point is the issue of embarrassment: even more so in an elderly population, there may be discomfort with doctor’s examinations on female patients. There tends to be greater comfort for patients with female doctors”, he says.

The risk of relapse with readmission of the patient to the hospital was also observed. This other marker of successful medical care had a disparity (ratio of 3.2%) for women treated by men compared to those treated by doctors.

The patient’s profile also tends to be different, says doctor Syomara Regina de Almeida, member of the Center for Education and Research Development (Cedep) at Iamspe. “Women take better care of themselves from an early age and are more accepting of treatments than men,” she notes.

To reduce research bias, scholars had to control several other possible variables. The idea was to ensure that the differences observed were caused by the doctor’s gender, and not by other possible factors.

Age, diagnosis at the time of admission, income level and other variables were taken into account. To classify doctors, in addition to gender, the level of training and specialization, volume of patients and the average performance of hospitals were considered – to make sure that a certain part of the sample was not being treated in places with better structures.

LIMITATIONS OF THE STUDYThe research focused on older patients admitted to hospitals for medical conditions and treated by hospitalists. Therefore, the results may not be generalizable to younger patients, patients with commercial insurance, those treated by other specialists, or patients receiving care in an outpatient setting.

Another limitation of the study is that Medicare data uses a binary gender classification and does not allow the identification of transgender patients. According to the experts interviewed, the study does not take into account all non-medical care, which involves therapists, nurses, nutritionists, among others – which can also influence.

“Of course, medical work is important, but the rest of the clinical staff is involved, it is difficult to bring this to just the doctor’s gender”, says Almeida. Finally, as the research was carried out in the USA, it is not possible to mirror the results for private medicine or the Brazilian SUS (Unified Health System), as it has a different cultural profile of doctor/patient, explains Neves.

The result of the research, in its considerations, suggests that investigation into this difference be in-depth so that scientists know whether this is reflected outside the USA or in young populations or those treated outside the hospital environment.

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