本文由小咖机器人翻译整理

期刊来源：Ann Intern Med

原文链接：https://doi.org/10.7326/M23-3163

摘要内容如下：

背景

很少有人知道医生性别对患者临床结果的影响是否因患者性别而异。

客观

研究医生性别与住院结果之间的关系是否在女性和男性住院患者之间存在差异。

设计

回顾性观察研究。

设置

医疗保险索赔数据。

病人

2016年至2019年期间，20%的医疗保险付费服务受益人因医疗条件住院并接受住院医师治疗的随机样本。

测量

主要结果是患者的30天死亡率和再入院率，根据患者和医生的特征以及医院水平的平均暴露量进行调整（有效比较同一医院的医生）。

结果

在458108名女性和318819名男性患者中，分别有142465名（31.1%）和97500名（30.6%）由女性医生治疗。女性和男性患者在接受女性医生治疗时死亡率均较低；然而，女性患者接受女医生护理的获益大于男性患者（双重差异，-0.16个百分点[pp][95%CI，-0.42至0.10 pp]）。对于女性患者，女性和男性医生之间的差异很大，并且具有临床意义（校正死亡率，8.15%对8.38%；平均边际效应[AME]，-0.24 pp[CI，-0.41 to-0.07 pp]）。对于男性患者，可以排除女性和男性医生之间的重要差异（10.15%对10.23%；相同，-0.08 pp[CI，-0.29至0.14 pp]）。患者的再入院率也是如此。

局限性

研究结果可能无法推广到年轻人群。

结论

研究结果表明，接受女医生治疗的患者死亡率和再入院率较低，女性患者接受女医生治疗的获益大于男性患者。

主要资金来源

格雷戈里·安纳伯格·温加滕，成长@安纳伯格。

英文原文如下：

Abstracts

BACKGROUND  Little is known as to whether the effects of physician sex on patients' clinical outcomes vary by patient sex.

OBJECTIVE  To examine whether the association between physician sex and hospital outcomes varied between female and male patients hospitalized with medical conditions.

DESIGN  Retrospective observational study.

SETTING  Medicare claims data.

PATIENTS  20% random sample of Medicare fee-for-service beneficiaries hospitalized with medical conditions during 2016 to 2019 and treated by hospitalists.

MEASUREMENTS  The primary outcomes were patients' 30-day mortality and readmission rates, adjusted for patient and physician characteristics and hospital-level averages of exposures (effectively comparing physicians within the same hospital).

RESULTS  Of 458 108 female and 318 819 male patients, 142 465 (31.1%) and 97 500 (30.6%) were treated by female physicians, respectively. Both female and male patients had a lower patient mortality when treated by female physicians; however, the benefit of receiving care from female physicians was larger for female patients than for male patients (difference-in-differences, -0.16 percentage points [pp] [95% CI, -0.42 to 0.10 pp]). For female patients, the difference between female and male physicians was large and clinically meaningful (adjusted mortality rates, 8.15% vs. 8.38%; average marginal effect [AME], -0.24 pp [CI, -0.41 to -0.07 pp]). For male patients, an important difference between female and male physicians could be ruled out (10.15% vs. 10.23%; AME, -0.08 pp [CI, -0.29 to 0.14 pp]). The pattern was similar for patients' readmission rates.

LIMITATION  The findings may not be generalizable to younger populations.

CONCLUSION  The findings indicate that patients have lower mortality and readmission rates when treated by female physicians, and the benefit of receiving treatments from female physicians is larger for female patients than for male patients.

PRIMARY FUNDING SOURCE  Gregory Annenberg Weingarten, GRoW @ Annenberg.

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