Clinical question: Are hospital mortality and readmission rates associated with physician sex, and do these associations vary by patient sex?
Background: Prior studies indicate that physician practice patterns vary by provider sex. However, evidence is limited as to whether the effect of physician sex on clinical outcomes varies by patient sex.
Study design: Retrospective observational study
Setting: Medicare claims data
Synopsis: A 20% random sample of Medicare beneficiaries hospitalized from 2016 to 2019 was analyzed. Primary outcomes were 30-day mortality and readmission rates, adjusted for patient and physician characteristics. Of the 776,927 patients, 31.1% of female and 30.6% of male patients were treated by female physicians. Both female and male patients had a lower 30-day mortality rate when treated by a female physician. For female patients, the difference between female and male physicians was statistically significant (8.15% versus 8.38%; average marginal effect (AME), −0.24%, 95% CI, −0.41 to −0.07). Both female and male patients had a lower adjusted readmission rate when treated by a female physician, which was statistically significant only for female patients (15.51% versus 16.01%; AME, −0.48%, CI, −0.72 to −0.24). One limitation is that sex was defined as a binary construct using the sex variable in the electronic databases and may not align with the gender identity of gender minority (transgender or nonbinary) patients and providers. Moreover, the results are limited to patients aged 65 or older and may not be generalizable to younger patients.
Bottom line: Although exact mechanisms are unclear, both female and male hospitalized patients had lower mortality and readmission rates when treated by female physicians. The benefit of receiving care from a female physician was larger for female patients than for male patients.
Citation: Miyawaki A, et al. Comparison of hospital mortality and readmission rates by physician and patient sex. Ann Intern Med. 2024;177(5):598-608.
Dr. Hernandez
Dr. Hernandez is a hospitalist in the division of hospital medicine at the Mount Sinai Health System and an assistant professor of medicine at the Icahn School of Medicine at Mount Sinai in