title: Gender disparities in AMI management and outcomes among health professionals, their relatives, and non-health professionals in Taiwan from 1997 to 2007.
abstract: Numerous reports of gender differences in the management and mortality of acute myocardial infarction (AMI) patients have raised concerns on gender inequity in cardiac care. However, no study has explored whether gender disparity exists among health professionals and their relatives. Therefore, this study assesses gender disparity in the management and mortality of AMI patients in Taiwan, and determines whether such disparity exists among health professionals and their relatives. National Health Insurance (NHI) files were used to obtain information on a cohort of 79,360 AMI patients aged 30-85 years in Taiwan from 1997 to 2007. The use of catheterization and revascularization (CATH/RAVS) and one-year mortality were compared between men and women in all adult patients, health professionals and their relatives, and non-health professional patients. Taiwanese women with AMI were significantly less likely than their male counterparts to receive CATH/RAVS, and showed greater one-year mortality. Similarly, women in the professional group were significantly less likely to receive CATH/RAVS. However, they did not have worse survival outcomes (hazard ratio: 1.01; 95% CI: 0.68-1.50) compared to men. Regarding mortality following CATH/RAVS, no gender disparities against women were observed in health professionals and their relatives, whereas significant gender disparities persisted in non-health professional patients. In conclusion, this study shows a substantial gender disparity against women in the management and one-year survival of AMI patients in Taiwan. This research extends earlier studies by showing similar gender gaps in treatment uses among health professionals and their relatives without strong evidence on gender disparities against women in survival.
authors.affiliation: Institute of Hospital and Health Care Administration, National Yang Ming University, Taipei, Taiwan. syhuang@ym.edu.tw
authors.forename: Nicole
authors.initials: N
authors.lastname: Huang
authors.forename: Yiing-Jenq
authors.initials: YJ
authors.lastname: Chou
authors.forename: Hsiao-Yun
authors.initials: HY
authors.lastname: Hu
authors.forename: Cheng-Hua
authors.initials: CH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D016208:Databases, Factual; D005190:Family; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D017678:Sex Distribution; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome