Effect of gender on treatment, resource utilization, and outcomes in congestive heart failure in Quebec, Canada

Area of Science:

• Cardiology
• Public Health
• Health Services Research

Background:

• Congestive heart failure (CHF) affects millions globally, with potential disparities in care based on gender.
• Understanding gender-based differences in treatment and outcomes is crucial for equitable healthcare delivery.

Purpose of the Study:

• To investigate potential gender disparities in the utilization of therapies and procedures for patients newly diagnosed with congestive heart failure (CHF).
• To compare clinical outcomes between men and women diagnosed with CHF at a population level.

Main Methods:

• A cohort of 16,017 men and 16,622 women diagnosed with CHF between 1998 and 2002 was identified using linked Quebec healthcare databases.
• Data included demographics, comorbidities, healthcare utilization (cardiologist visits, hospital stay), procedures (left ventricular function assessment, cardiac catheterization, revascularization), medication use (ACE inhibitors, beta-blockers), and mortality.
• Statistical analyses were performed to compare characteristics, treatment patterns, and outcomes between genders, adjusting for relevant factors.

Main Results:

• Women with CHF were older and had higher rates of hypertension and hyperlipidemia but lower rates of myocardial infarction compared to men.
• Women were less likely to see a cardiologist, undergo diagnostic cardiac catheterization or revascularization, and were prescribed ACE inhibitors less frequently.
• Despite these differences in care, women and men had similar rates of CHF rehospitalization and emergency room visits, with a minimally higher adjusted risk of death in men.

Conclusions:

• This population-level study indicates that women with newly diagnosed congestive heart failure receive less aggressive cardiac care, including fewer procedures and less frequent specialist consultations.
• However, clinical outcomes, including mortality and rehospitalization rates, were similar between men and women with CHF.
• Further research is warranted to explore the reasons for these observed treatment patterns and to ensure optimal, equitable care for all CHF patients.