Sex differences in patterns of referral and resource utilization in the cardiology clinic: an outpatient analysis

Area of Science:

• Cardiology
• Health Services Research
• Sex Differences in Medicine

Background:

• Management patterns in specialized cardiac care may differ between sexes.
• Understanding these differences is crucial for equitable healthcare delivery.

Purpose of the Study:

• To assess potential sex differences in referral patterns, management, and outcomes for patients attending outpatient cardiology consultations.
• To identify disparities in cardiac care based on sex.

Main Methods:

• Retrospective observational analysis of 5,974 new patients (2017-2018) referred to a tertiary cardiology clinic.
• Comparison of referral reasons, management decisions, and 24-month post-visit outcomes between men and women.
• Analysis included age-related referral rates, common consultation reasons, hospitalizations, mortality, and emergency department visits.

Main Results:

• Women were referred at higher age-related rates, with palpitations as a common reason versus ECG abnormalities in men.
• Despite similar delays in care, women had significantly fewer cardiology hospitalizations (5.8% vs. 9.3%) and lower mortality (1.8% vs. 2.7%).
• Women under 65 had more emergency department visits (48.5% vs. 39.9%) compared to men.

Conclusions:

• Substantial sex differences are evident in primary care cardiology referral patterns, management decisions, and patient outcomes.
• These disparities are only partially explained by age, necessitating further research into the underlying reasons.
• Investigating the drivers of these sex-based differences is essential for improving cardiac care equity.