Female Internists Outperform Males on Key Post-Discharge Outcomes



Female internists in the US are achieving better post-discharge outcomes than males, by a margin of 3-4%. Readmission and mortality rates are half a percentage point lower when the internist is female. These are the findings of Yusuke Tsugawa, Ashish Jha and colleagues from Harvard in a recent issue of JAMA, based on a study of 1.5 million Medicare patients and almost 60,000 physicians. (Full article: Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians.)

The authors have done an excellent job of ruling out other factors that could conceivably have caused these differences. Factors controlled included characteristics of the patients, the hospitals in question, and the physicians themselves. No matter what type of control was used or what statistical method, the differences remained.

It is debatable whether, at 3-4%,​ these differences are large enough to matter to an individual patient, but they certainly will matter to hospitals and health care organizations. (For comparison, a 4% difference is about a third as large as the usual “ReInforced Care effect” on 30-day readmission rate.) The authors share insights about the possible reasons for their findings, based on past research, but the current study is chiefly focused on establishing that these gender-based differences do in fact exist.

– February 27, 2017