Association Between Surgeon Sex and Days Alive at Home Following Surgery: A Population-Based Cohort Study

Kiyan Heybati, From the Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, MN.
Raj Satkunasivam, Center for Outcomes Research, Houston Methodist Hospital, Houston, TX.
Khatereh Aminoltejari, Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Hannah S. Thomas, Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Arghavan Salles, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA.
Natalie Coburn, Department of Surgery, Sunnybrook Health Sciences Center, Toronto, ON, Canada.
Frances C. Wright, Department of Surgery, Sunnybrook Health Sciences Center, Toronto, ON, Canada.
Lesley Gotlib Conn, Department of Surgery, Sunnybrook Health Sciences Center, Toronto, ON, Canada.
Amy N. Luckenbaugh, Department of Urology, Vanderbilt University Medical Center, Nashville, TN.
Sanjana Ranganathan, Department of Urology, Houston Methodist Hospital, Houston, TX.
Carlos Riveros, Department of Urology, Houston Methodist Hospital, Houston, TX.
Colin McCartney, Department of Anesthesia, Sunnybrook Health Sciences Center, Toronto, ON, Canada.
Kathleen Armstrong, Division of Plastic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Barbara Bass, George Washington University, School of Medicine and Health Sciences, WA.
Allan S. Detsky, Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Angela Jerath, Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Christopher J. Wallis, Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.

Document Type

Journal Article

Publication Date

9-1-2024

Journal

Annals of surgery open : perspectives of surgical history, education, and clinical approaches

Volume

5

Issue

3

DOI

10.1097/AS9.0000000000000477

Keywords

cohort study; diversity; patient outcomes; physician sex

Abstract

OBJECTIVE: The objective of this study was to measure potential associations between surgeon sex and number of days alive and at home (DAH). BACKGROUND: Patients treated by female surgeons appear to have lower rates of mortality, complications, readmissions, and healthcare costs when compared with male surgeons. DAH is a validated measure, shown to better capture the patient experience of postoperative recovery. METHODS: We conducted a retrospective study of adults (≥18 years of age) undergoing common surgeries between January 01, 2007 and December 31, 2019 in Ontario, Canada. The outcome measures were the number of DAH within 30-, 90-, and 365-days. The data was summarized using descriptive statistics and adjusted using multivariable generalized estimating equations. RESULTS: During the study period, 1,165,711 individuals were included, of which 61.9% (N = 721,575) were female. Those managed by a female surgeon experienced a higher mean number of DAH when compared with male surgeons at 365 days (351.7 vs. 342.1 days; P < 0.001) and at each earlier time point. This remained consistent following adjustment for covariates, with patients of female surgeons experiencing a higher number of DAH at all time points, including at 365 days (343.2 [339.5-347.1] vs. 339.4 [335.9-343.0] days). Multivariable regression modeling revealed that patients of male surgeons had a significantly lower number of DAH versus female surgeons. CONCLUSIONS: Patients of female surgeons experienced a higher number of DAH when compared with those treated by male surgeons at all time points. More time spent at home after surgery may in turn lower costs of care, resource utilization, and potentially improve quality of life. Further studies are needed to examine these findings across other care contexts.

Department

Surgery

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