Women’s medical care is inferior in emergency departments and post-op
October 28, 2024
Two recent studies document that women may receive medical care inferior to the care delivered to men.
Source: Wagner, et al JAMA Surgery October 16, 2024
The first, published in JAMA Surgery, reviewed the medical claims for over 860,000 Medicare beneficiaries who had one of four high risk cardiac and vascular surgeries from 2015-2020. They found that female patients were statistically significantly more likely to have serious complications or die, and have “failure to rescue,” where their symptoms were not recognized and acted upon promptly. Male patients were more likely to have a re-operation, which in many instances could have been lifesaving. The researchers risk-adjusted the results for a wide range of factors, including size and staffing of the treating hospital. They suggest that implicit bias may play a role and suggest better provider education. They also point to the need to report on results based on gender to identify such disparities.
Pain treatment by gender
Source: Guzekevits, et al PNAS August, 2024. The right side shows that for the same amount of reported pain (scale of 0-10), women were less likely to receive a pain relieving medication.
The second study, published in Proceedings of the National Academy of Science, showed that women receive later and less treatment for pain in emergency departments in the US and Israel. This research was published in August and was featured in the Washington Post this week. Researchers reviewed clinical records of 21,851 patients seen in emergency departments in the US and Israel and found that women’s pain was less likely to be documented, and when documented was less likely to be treated with pain medication. Women, on average, spent 30 additional minutes in the emergency department. Female, as well as male, treating physicians gave female patients less pain medication than they gave men with the same pain scores. Researchers also performed a small study that showed nurses rated pain lower in written case studies if the patient was identified as female.
Implications for employers:
Improving recognition of complications that female patients have after major surgery can lead to better survival rates and lower medical costs.
Delay in treatment and longer emergency department visits can lead to higher medical costs.
Employers can ask medical carriers what they are doing to identify and address areas of gender disparity.