(HealthDay News) — Female Medicare beneficiaries undergoing coronary artery bypass grafting are more likely to receive care at low-quality hospitals than male beneficiaries, with a greater sex disparity in mortality at low-quality hospitals, according to a study published online June 11 in JAMA Network Open.
Catherine M. Wagner, MD, and Andrew M. Ibrahim, MD, from the University of Michigan in Ann Arbor, examined sex disparities in 30-day mortality after coronary artery bypass grafting across high- and low-quality hospitals in a cross-sectional, retrospective cohort study. A total of 444,855 beneficiaries were analyzed (27.1 and 72.9% female and male, respectively).
The researchers found that female beneficiaries were more likely to have an unplanned admission than male beneficiaries, and they were more likely to receive care at low- versus high-quality hospitals (odds ratio, 1.26). Risk-adjusted female and male mortality was 4.24 and 2.75%, respectively, overall, with an absolute difference of 1.48 percentage points. Male and female mortality was 1.57 and 2.58% at the highest-quality hospitals, compared with 4.94 and 7.02% at the lowest-quality hospitals (absolute differences, 1.01 and 2.07 percentage points, respectively). More than fourfold higher mortality was seen for female beneficiaries receiving care at low-quality hospitals than male beneficiaries who received care at high-quality hospitals (7.02 versus 1.57%).
“Policy aimed at equitable referral of female patients to high-quality centers and targeted improvement of low-quality hospitals may narrow these disparities,” the authors write.
