Surgeon Sex and Postoperative Resource Utilization: A Population-Based Cohort Study
Document Type
Journal Article
Publication Date
6-1-2025
Journal
Annals of surgery open : perspectives of surgical history, education, and clinical approaches
Volume
6
Issue
2
DOI
10.1097/AS9.0000000000000569
Keywords
cohort study; diversity; patient outcomes; physician sex; resource use
Abstract
OBJECTIVES: To determine associations between physician sex and use of postoperative healthcare resources among patients undergoing common surgeries in Ontario, Canada. BACKGROUND: Prior studies have shown that patients of female physicians experience better outcomes and have lower healthcare costs compared with patients of male physicians. Understanding differences in resource utilization may offer insights into the care pathways and practice patterns contributing to these differences. METHODS: We conducted a population-based, retrospective cohort study of adults (≥18 years of age) undergoing 1 of 25 common surgeries, between January 1, 2007, and December 31, 2019, in Ontario, Canada. The primary outcome was the utilization of one of the following: intensive care unit admission, other medical interventions (eg, tracheostomy, new dialysis starts, and home oxygen), and discharge care needs (eg inpatient rehab, long-term care, and home care use) within 30 days. The data were summarized using descriptive statistics and adjusted using multivariable generalized estimating equations. RESULTS: This population-based study included 1,100,193 patients (61.8% female). Patients treated by male surgeons had higher use of postoperative resources versus those with female surgeons within 30 days (adjusted rate 33.1; 95% confidence interval [CI]: 28.0-39.2 versus 31.2; 95% CI: 25.8-37.7), 90 days, and 1 year. Consistent with these findings, following adjustment for patient, surgeon, procedural, and hospital characteristics, patients treated by male surgeons were significantly more likely to utilize postoperative resources within 30 days (adjusted odds ratio: 1.14; 95% CI: 1.03-1.27; P = 0.010) and at other time points. This difference was primarily driven by the higher use of home care among patients with a male versus female surgeon at all time points (30 days: adjusted odds ratio, 1.13; 95% CI: 1.05-1.21; P = 0.002). CONCLUSIONS: Patients with male surgeons had higher postoperative resource utilization when compared with those treated by female surgeons, which was almost entirely driven by the higher use of home care. Further mixed-methods investigation is needed to better understand other potentially relevant factors including surgical outcomes, individual patient preferences, and surgical team decision-making.
APA Citation
Heybati, Kiyan; Satkunasivam, Raj; Aminoltejari, Khatereh; Thomas, Hannah S.; Salles, Arghavan; Coburn, Natalie; Wright, Frances C.; Gotlib Conn, Lesley; Luckenbaugh, Amy N.; Ranganathan, Sanjana; Riveros, Carlos; Sutherland, Jason; McCartney, Colin; Armstrong, Kathleen; Bass, Barbara; Detsky, Allan S.; Jerath, Angela; and Wallis, Christopher J., "Surgeon Sex and Postoperative Resource Utilization: A Population-Based Cohort Study" (2025). GW Authored Works. Paper 7475.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/7475
Department
Surgery