Physician gender is associated with the quality of type 2 diabetes care.
OBJECTIVE
Patient gender influences the quality of medical care whilst the role of physician gender is not well established. To investigate the influence of physician gender on quality of care in patients with type 2 diabetes.


METHODS
Cross-sectional study in 51 053 outpatients (48.6% male), treated by 3096 office-based physicians (66.3% male; 74.0% general practitioners, 21.8% internists and 4.2% diabetologists). Outcome measures included processes of care, intermediate outcomes and medical management. Quality of care measures were based on current ADA guidelines. Hierarchical regression models were used to avoid case-mix bias and to correct for physician-level clustering. Adjusted odds ratios were calculated controlling for age, gender, disease duration and presence of atherosclerotic disease.


RESULTS
The patients of female physicians were more often women, more obese, older and had more often atherosclerotic disease (34% in the total cohort). The patients of female physicians more often reached target values in glycaemic control (HbA1c < 6.5%; OR 1.14; 1.05-1.24, P = 0.002), blood lipoproteins (LDL-C < 100 mg dL(-1); OR 1.16; 1.06-1.27, P = 0.002), and blood pressure (systolic values < 130 mmHg; OR 1.11; 1.02-1.22, P = 0.018). They were more likely to receive antihypertensive drug therapy in general (OR 1.35; 1.24-1.46, P < 0.0001) and angiotensin converting enzyme (ACE) inhibitors in particular (OR 1.17; 1.09-1.25, P < 0.0001). The patients of female physicians less often performed glucose self-monitoring (OR 0.83; 0.76-0.91, P < 0.0001) and less often received oral hypoglycaemic agents (OR 0.88; 0.82-0.95, P = 0.001).


CONCLUSIONS
Physician gender influences quality of care in patients with type 2 diabetes. Female physicians provide an overall better quality of care, especially in prognostically important risk management.
Berthold
H K
HK
Clinical Pharmacology Division, Medical Faculty, University of Bonn, Bonn, Germany.
Gouni-Berthold
I
I
Bestehorn
K P
KP
Böhm
M
M
Krone
W
W
D000368:Aged; D050197:Atherosclerosis / Q000150:complications; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000628:therapy*; D005194:Family Practice / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D010349:Patient Compliance; D010817:Physician-Patient Relations; D010820:Physicians; D010822:Physicians, Women; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011785:Quality Assurance, Health Care; D012044:Regression Analysis; D012737:Sex Factors; D016896:Treatment Outcome