Simone Krähenmann-Müller1, Vanessa S Virgini1, Manuel R Blum1, Bruno R da Costa2, Tinh-Hai Collet3, Yonas Martin4, Jacques Cornuz4, Lukas Zimmerli5, Jean-Michel Gaspoz6, Douglas C Bauer7, Eve A Kerr8, Drahomir Aujesky1, Nicolas Rodondi9. 1. Department of General Internal Medicine, Inselspital, University of Bern, Bern, Switzerland. 2. Department of General Internal Medicine, Inselspital, University of Bern, Bern, Switzerland; CTU Bern, Department of Clinical Research and Institute of Social, and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland. 3. Department for Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland; Service of Endocrinology, Diabetes, and Metabolism, Lausanne University Hospital, Lausanne, Switzerland. 4. Department for Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland. 5. Division of Internal Medicine, University Hospital of Zürich, Zürich, Switzerland. 6. Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland. 7. Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA, United States. 8. Division of General Internal Medicine, Department of Medicine, School of Medicine, University of Michigan, MI, United States; Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, United States. 9. Department of General Internal Medicine, Inselspital, University of Bern, Bern, Switzerland. Electronic address: Nicolas.Rodondi@insel.ch.
Abstract
OBJECTIVE: To assess the quality of preventive care according to physician and patient gender in a country with universal health care coverage. METHODS: We assessed a retrospective cohort study of 1001 randomly selected patients aged 50-80 years followed over 2 years (2005-2006) in 4 Swiss university primary care settings (Basel, Geneva, Lausanne, Zürich). We used indicators derived from RAND's Quality Assessment Tools and examined percentages of recommended preventive care. Results were adjusted using hierarchical multivariate logistic regression models. RESULTS: 1001 patients (44% women) were followed by 189 physicians (52% women). Female patients received less preventive care than male patients (65.2% vs. 72.1%, p<0.001). Female physicians provided significantly more preventive care than male physicians (p=0.01) to both female (66.7% vs. 63.6%) and male patients (73.4% vs. 70.7%). After multivariate adjustment, differences according to physician (p=0.02) and patient gender (p<0.001) remained statistically significant. Female physicians provided more recommended cancer screening than male physicians (78.4 vs. 71.9%, p=0.01). CONCLUSIONS: In Swiss university primary care settings, female patients receive less preventive care than male patients, with female physicians providing more preventive care than male physicians. Greater attention should be paid to female patients in preventive care and to why female physicians tend to provide better preventive care.
OBJECTIVE: To assess the quality of preventive care according to physician and patient gender in a country with universal health care coverage. METHODS: We assessed a retrospective cohort study of 1001 randomly selected patients aged 50-80 years followed over 2 years (2005-2006) in 4 Swiss university primary care settings (Basel, Geneva, Lausanne, Zürich). We used indicators derived from RAND's Quality Assessment Tools and examined percentages of recommended preventive care. Results were adjusted using hierarchical multivariate logistic regression models. RESULTS: 1001 patients (44% women) were followed by 189 physicians (52% women). Female patients received less preventive care than male patients (65.2% vs. 72.1%, p<0.001). Female physicians provided significantly more preventive care than male physicians (p=0.01) to both female (66.7% vs. 63.6%) and male patients (73.4% vs. 70.7%). After multivariate adjustment, differences according to physician (p=0.02) and patient gender (p<0.001) remained statistically significant. Female physicians provided more recommended cancer screening than male physicians (78.4 vs. 71.9%, p=0.01). CONCLUSIONS: In Swiss university primary care settings, female patients receive less preventive care than male patients, with female physicians providing more preventive care than male physicians. Greater attention should be paid to female patients in preventive care and to why female physicians tend to provide better preventive care.
Authors: Christine M Gunn; Nancy R Kressin; Kristina Cooper; Cinthya Marturano; Karen M Freund; Tracy A Battaglia Journal: J Womens Health (Larchmt) Date: 2018-01-17 Impact factor: 2.681