Sex differences in cardiac catheterization: the role of physician gender

Area of Science:

• Cardiology
• Health Services Research
• Medical Bias

Background:

• Studies show women are less likely than men to undergo cardiac procedures post-acute myocardial infarction (AMI).
• Concerns exist regarding potential sexual bias in clinical care for AMI patients.
• No prior data examined the interplay of patient sex, physician sex, and cardiac procedure utilization.

Purpose of the Study:

• To investigate if sex differences in cardiac catheterization rates after AMI are amplified when patients are treated by male physicians versus female physicians.
• To determine the influence of physician sex on sex-based disparities in cardiac procedure use following AMI.

Main Methods:

• Retrospective analysis of the Cooperative Cardiovascular Project database.
• Included over 104,231 Medicare beneficiaries hospitalized for AMI between January 1994 and February 1995.
• Compared cardiac catheterization use within 60 days of admission across four patient sex-physician sex groups.

Main Results:

• Women underwent fewer cardiac catheterizations than men, regardless of physician sex (38.6% vs 50.8% for male physicians; 34.8% vs 45.8% for female physicians).
• No significant interaction was found between patient sex and physician sex regarding procedure use (P=.85).
• Multivariable analysis confirmed women were less likely to undergo catheterization (RR, 0.90; 95% CI, 0.88-0.92), and patients treated by male physicians were more likely (RR, 1.06; 95% CI, 1.02-1.10), irrespective of patient sex.

Conclusions:

• Women with AMI consistently undergo cardiac catheterization less frequently than men, irrespective of their physician's sex.
• These findings indicate that factors other than male physician sexual bias contribute to observed sex differences in cardiac procedure utilization.
• Further research is needed to identify the underlying causes of these persistent disparities in cardiovascular care for women.