Gender of Physician as the Usual Source of Care and Patient Health Care Utilization and Mortality

Abstract

Practice styles differ by provider gender, but whether provider gender influences health care utilization and mortality is unknown. The objective of this study was to examine associations of the gender of a patient's usual source of health care (USOC) with health care utilization and mortality. This was a prospective observational study employing data from respondents aged ≥18 years entering the 2002 to 2008 United States Medical Expenditure Panel Surveys, reporting a USOC at entry, and participating for 2 years (N = 21,365). Analyses examined the association of gender of the USOC in survey participation year 1 with the following health care utilization outcomes in participation year 2: total health care expenditures, prescription drug expenditures, and number of office visits (Poisson regressions) and having more than one emergency visit and more than one hospitalization (logistic regressions). A Cox regression examined survival (ascertained via linkage with the National Death Index) through 2006 for the subset of respondents enrolled from 2002 to 2006 (n = 11,328). All analyses were adjusted for respondent sociodemographic and health characteristics and USOC specialty and race/ethnicity. Reporting a female USOC was associated with being younger, female, and urban. There were no significant adjusted associations of female USOC status with total expenditures (parameter estimate of increase [PE], 4.56%; 95% confidence interval [CI], -3.04 to 12.76), prescription expenditures (PE, 3.33% ; 95% CI, -4.32 to 11.59), number of office visits (PE, 1.28%; 95% CI, -3.30 to 6.08), having more than one emergency visit (odds ratio, 0.98; 95% CI, 0.87-1.11), having more than one hospitalization (odds ratio, 0.98; 95% CI, 0.87-1.11), or mortality (hazard ratio, 0.94; 95% CI, 0.64-1.38). Gender of the USOC was not associated with health care utilization or mortality. These findings suggest reported gender of the USOC may not have nationally important effects on health care utilization and mortality.