Comparison of hospital complications and mortality for stroke patients treated by male vs female physicians: a propensity-score matched study

Abstract

Background: The association between physician gender and the outcomes of stroke patients is not yet fully understood. The aim of this study was to evaluate outcomes after stroke hospitalization between patients who received female physicians’ care (FPC) vs male physicians’ care (MPC). Methods: We used Taiwan’s National Health Insurance Research Database 2000-2009 claims data to conduct a stroke cohort study that included 493,223 hospitalized stroke patients. Using a matching procedure by propensity score, we selected 25,160 stroke patients with FPC and 25,160 stroke patients with MPC for comparison. Logistic regression was used to calculate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of poststroke complications and in-hospital mortality between patients with FPC and MPC. Results: Compared with patients with MPC, stroke patients with FPC had significantly lower risks of poststroke pneumonia (OR 0.87, 95% CI 0.81-0.94), septicemia (0.79, 95% CI 0.70-0.88), acute renal failure (OR 0.78, 95% CI 0.65-0.95), admission to the intensive care unit (OR 0.73, 95% CI 0.69-0.77), and 30-day in-hospital mortality (OR 0.64, 95% CI 0.55-0.75). However, the risk of urinary tract infection (OR 1.16, 95% 1.09-1.23) was higher in patients with FPC than in those with MPC. Lower rates of poststroke adverse events in patients with FPC were noted in further analysis, including different morbidities and various types of stroke. Conclusions: Stroke patients with FPC showed reduced complications and mortality compared with MPC patients. Our findings warrant randomized control trials in the future to validate the influence of physician gender on stroke outcomes.