JAMA子刊:被女医生治疗的重病患者,死亡率更低!

2016-12-21 生物探索 生物探索

导读 根据哈佛公共卫生学院的最新研究,由女性医生治疗的老年住院患者在入院后30天内死亡或在出院后30天内重新住院的概率低于由男性医师照顾的患者。这项研究在线发表于12月19日的JAMA Internal Medicine杂志上,首次记录了男性和女性医生治疗住院患者的结果差异。虽然人类已经步入21世纪,但医疗界的性别歧视仍然随处可见。不仅国内的医院招聘更倾向于男医生,即使在美国,男医生与女医生的薪酬

导读 根据哈佛公共卫生学院的最新研究,由女性医生治疗的老年住院患者在入院后30天内死亡或在出院后30天内重新住院的概率低于由男性医师照顾的患者。这项研究在线发表于12月19日的JAMA Internal Medicine杂志上,首次记录了男性和女性医生治疗住院患者的结果差异。


虽然人类已经步入21世纪,但医疗界的性别歧视仍然随处可见。不仅国内的医院招聘更倾向于男医生,即使在美国,男医生与女医生的薪酬也存在近2万美金的差距。男医生比女医生能力更强吗?事实可能恰恰相反——根据哈佛公共卫生学院的最新研究,由女医生治疗的老年住院患者在入院后30天内死亡或在出院后30天内重新住院的概率低于由男性医师照顾的患者。这项研究在线发表于12月19日的JAMA Internal Medicine杂志上,首次记录了男性和女性医生治疗住院患者的结果差异。

研究人员估计,如果男医生能够达到与女医生相同的诊疗结果,每年医保患者死亡人数将减少32000人——这个数字与美国每年的机动车事故死亡人数相当。

“死亡率的差异令人惊讶。”该研究主要作者,卫生政策和管理部研究员Yusuke Tsugawa说。 “医生的性别似乎对重病患者特别重要。这些发现表明,男医生和女医生诊疗模式的潜在差异可能有重要的临床意义。

此前的研究发现男医生和女医生的诊疗方式存在差异。例如,女医生可能更加遵守临床指南,并提供更多以患者为中心的沟通——但该研究首次调查了男医生和女医生的诊疗方式差异对临床结果的影响。

研究人员分析了超过100万年龄65岁或以上的医保病人的数据,他们在医疗条件下住院,并在2011年至2014年期间由普通内科医生治疗。研究人员调整患者和医师特征的差异,并考虑患者结局的差异是否受到特定疾病或疾病严重程度的影响。

研究人员发现,如果接受女医生治疗,患者提前死亡的相对风险降低4%,并且在30天内重新住院的相对风险降低5%。在各种各样的临床病症和疾病严重程度的差异中仍可见这种关联。当研究人员将他们的分析限于住院医生——这些专注于医院护理的医生通常根据工作日程表被随机分配患者,结果仍然保持一致,这意味着患者选择——相对健康的患者可能选择某些类型的医生,不是一个影响因素。

女医生现在占美国医生人数的三分之一,占美国医学院毕业生的一半。主要作者Ashish Jha表示,女医生的待遇有着明显的性别差异——她们不太可能被晋升,通常来说收入也较少。一些人认为女医生通常比男医生要担负更多的家庭责任,这可能导致她们在工作上的分心,本研究为反驳这种观点提供了确凿的证据。

“我们的研究有充分的证据表明男性和女性医生的诊疗方法不同,结果表明,这些差异对患者的健康十分重要。我们需要了解女医生为什么能够降低死亡率,以便使所有患者,不管他们的主治医生是男是女,都能达到最好的治疗结果。”Jha说。

原始出处:

[2] Yusuke Tsugawa, MD, MPH, PhD,et al. Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians. JAMA Intern Med.December 19, 2016

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1898264, encodeId=f306189826400, content=<a href='/topic/show?id=cd734459445' target=_blank style='color:#2F92EE;'>#女医生#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44594, encryptionId=cd734459445, topicName=女医生)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Sun May 21 09:06:00 CST 2017, time=2017-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=168155, encodeId=2445168155ce, content=为啥啊?, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRvvXNvY0kOJqn4liar3Q6V6yPuEIawCVUyP3jVADh5icIz0ibrsxia6fKAqKsDr33jPWrjqM3D7wcRNu/0, createdBy=5a881701729, createdName=小树熊, createdTime=Thu Jan 05 16:40:23 CST 2017, time=2017-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=164686, encodeId=6f471646868d, content=必须的, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Wed Dec 21 19:52:30 CST 2016, time=2016-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=164605, encodeId=dac6164605f4, content=噢这么回事,下次看病找女医生, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Wed Dec 21 10:20:28 CST 2016, time=2016-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=164602, encodeId=aae616460229, content=我是女医生, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160616/IMG5762A3665DC7B3997.jpg, createdBy=df0a1649089, createdName=ys2323, createdTime=Wed Dec 21 10:15:41 CST 2016, time=2016-12-21, status=1, ipAttribution=)]
    2017-01-05 小树熊

    为啥啊?

    0

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    2016-12-21 1dd8c52fm63(暂无匿称)

    必须的

    0

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    2016-12-21 186****0580(小山羊)

    噢这么回事,下次看病找女医生

    0

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    2016-12-21 ys2323

    我是女医生

    0

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