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Quality of care

Is there a serious gender based bias in the quality of patient care?

Overall, the answer appears to be no. However,  the following gender based differences in heart failure patient care were discovered:

  • Studies have shown that physicians are less likely to record findings in their initial physical examinations of women [21][22][20]

  • Women undergo fewer treatment procedures [42][43][44][20]

  • Women are less likely to be treated by a cardiologist

  • Women are less likely to be referred to a teaching hospital or to be transferred to other acute-care hospitals [21][22][41][20]

  • Women tend to spend more time in hospital than men [45]

  • Women are more commonly discharged to skilled nursing facilities

    • Due to the fact that they are usually elderly, widowed and should not be living alone [45]

 

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20. Philbin EF, DiSalvo TG.Influence of race and gender on care process, resource use and outcomes in congestive heart failure. Am J Cardiol 1998;82:76 –81.

21. Clarke KW, Gray D, Hampton JR.Evidence of inadequate investigation and treatment of patients with heart failure.Br Heart J 1994;71:584 –7.

22. Ayanian JZ, Weissman JS, Chasan-Taber S, Epstein AM. Quality of care by race and gender for congestive heart failure and pneumonia.Med Care 1999;37:1260 –9.

41. Taubert G, Bergmeier C, Andresen H, Senges J, Potratz J. Clinical profile and management of heart failure: rural community hospital vs.metr opolitan heart center. Eur J Heart Fail 2001;3:611 –7.

42. McMurray J, McDonagh T, Morrison CE, Dargie HJ.T rends in hospitalization for heart failure in Scotland 1980–1990.Eur Heart J 1993;14:1158 –62.

43. Doughty R, Yee T, Sharpe N, MacMahon S.Hospital admissions and deaths due to congestive heart failure in New Zealand.N Z Med J 1995;108:474 –5.

44. Reitsma JB, Mosterd A, de Craen AJM, Koster RW, van Capelle FJL, Grobbee DE, Tijssen JGP.Incr ease in hospital admission rates for heart failure in the Netherlands, 1980– 1993.Heart 1996;76:388 –92.

45. Chin MH, Goldman L.Gender differences in 1-year survival and quality of life among patients admitted with congestive heart failure.Med Care 1998;36:1033 –46.

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