Rosalind Raine1, C Goldfrad, K Rowan, N Black. 1. Health Services Research Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. rosalind.raine@lshtm.ac.uk
Abstract
STUDY OBJECTIVES: To compare the case mix and outcomes of male and female patients admitted to intensive care units for a wide range of conditions. DESIGN: Cross sectional study of prospectively collected data. SETTING: The Intensive Care National Audit and Research Centre, (ICNARC) Case Mix Programme. PARTICIPANTS: 46 587 admissions to 91 units across England, Wales, and Northern Ireland. MAIN RESULTS: No gender differences were found in case mix on admission or in mortality for five conditions (cardiac arrhythmia, chronic obstructive airways disease, asthma, self poisoning, and seizures). There was some evidence of horizontal and vertical inequity for female patients with myocardial infarction and with neurological bleeding. Vertical equity was not achieved for male pneumonia and ventricular failure patients and for women with primary brain injury. CONCLUSIONS: This study demonstrated, for the first time, possible inequitable use of intensive care for patients with certain conditions. This may be secondary to gender bias and can result in either over-treatment in the favoured group, or under-treatment in the neglected group. It would therefore be pertinent to re-examine these findings using other databases, and to further investigate the causative factors, including gender bias.
STUDY OBJECTIVES: To compare the case mix and outcomes of male and female patients admitted to intensive care units for a wide range of conditions. DESIGN: Cross sectional study of prospectively collected data. SETTING: The Intensive Care National Audit and Research Centre, (ICNARC) Case Mix Programme. PARTICIPANTS: 46 587 admissions to 91 units across England, Wales, and Northern Ireland. MAIN RESULTS: No gender differences were found in case mix on admission or in mortality for five conditions (cardiac arrhythmia, chronic obstructive airways disease, asthma, self poisoning, and seizures). There was some evidence of horizontal and vertical inequity for female patients with myocardial infarction and with neurological bleeding. Vertical equity was not achieved for male pneumonia and ventricular failurepatients and for women with primary brain injury. CONCLUSIONS: This study demonstrated, for the first time, possible inequitable use of intensive care for patients with certain conditions. This may be secondary to gender bias and can result in either over-treatment in the favoured group, or under-treatment in the neglected group. It would therefore be pertinent to re-examine these findings using other databases, and to further investigate the causative factors, including gender bias.
Authors: S Y Bögli; D Utebay; N Smits; L P Westphal; L Hirsbrunner; S Unseld; E Keller; G Brandi Journal: Acta Neurochir (Wien) Date: 2022-08-19 Impact factor: 2.816
Authors: Giovanna Brandi; Vittorio Stumpo; Marco Gilone; Lazar Tosic; Johannes Sarnthein; Victor E Staartjes; Sophie Shih-Yüng Wang; Bas Van Niftrik; Luca Regli; Emanuela Keller; Carlo Serra Journal: Medicine (Baltimore) Date: 2022-07-08 Impact factor: 1.817
Authors: Robert A Fowler; Natasha Sabur; Ping Li; David N Juurlink; Ruxandra Pinto; Michelle A Hladunewich; Neill K J Adhikari; William J Sibbald; Claudio M Martin Journal: CMAJ Date: 2007-11-14 Impact factor: 8.262
Authors: Michael C Reade; Sachin Yende; Gina D'Angelo; Lan Kong; John A Kellum; Amber E Barnato; Eric B Milbrandt; Christopher Dooley; Florian B Mayr; Lisa Weissfeld; Derek C Angus Journal: Crit Care Med Date: 2009-05 Impact factor: 7.598