Treatment by Female Clinicians Associated with Lower Mortality, Hospital Readmissions: Daily Dose

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Last week, we reported on findings from a study published in the Annals of Internal Medicine that examined whether the association between physician sex and hospital outcomes varied between women and men hospitalized with medical conditions.

The study

For the retrospective observational study, investigators collected a 20% random sample of Medicare fee-for-service beneficiaries hospitalized with medical conditions as defined by the Medicare Severity Diagnosis Related Group, between January 2016 and December 2019.

The exposure variables were 4 patient-physician dyads: female patient–female physician, female patient–male physician, male patient–female physician, and male patient–male physician and the study’s primary outcomes were patient mortality and readmission rates 30-days post discharge, adjusted for patient and physician characteristics as well as hospital level averages of exposures.

The final sample for analysis included 458 108 women and 318 819 men aged 65 years and older. Female physicians treated 31.1% of female patients and 30.6% of male patients.

The findings

Although 30-day mortality rates were lower for both men and women treated by female physicians, female patients experienced a significantly greater benefit (difference-in-differences, -0.16 percentage points [pp], 95% CI, -0.42 to 0.10 pp).

Female patients had a lower mortality rate (8.15%) when treated by female physicians compared to when treated by male physicians (8.38%) (average marginal effect [AME], -0.24, 95% CI, - 0.41 to -0.07). The mortality rate for men treated by female physicians was only slightly lower than for men treated by male physicians (10.15% vs 10.23; AME, -0.08, 95% CI, -0.29 to 0.14).

The results for 30-day readmission followed a similar pattern, with rates lower for men and women treated by female physicians. For women, the difference in readmissions between female and male physicians was clinically important (15.51% vs. 16.01%; AME, -0.48, 95% CI, -0.72 to -0.24) but for men, the difference did not reach statistical significance (15.65% vs 15.87%).

Authors' comment

“Further research on the underlying mechanisms linking physician gender with patient outcomes, and why the benefit of receiving the treatment from female physicians is larger for female patients, has the potential to improve patient outcomes across the board.”

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