title: Patient and physician gender concordance in preventive care in university primary care settings.
abstract: OBJECTIVE
  To assess the quality of preventive care according to physician and patient gender in a country with universal health care coverage.
  
  
  METHODS
  We assessed a retrospective cohort study of 1001 randomly selected patients aged 50-80 years followed over 2 years (2005-2006) in 4 Swiss university primary care settings (Basel, Geneva, Lausanne, Zürich). We used indicators derived from RAND's Quality Assessment Tools and examined percentages of recommended preventive care. Results were adjusted using hierarchical multivariate logistic regression models.
  
  
  RESULTS
  1001 patients (44% women) were followed by 189 physicians (52% women). Female patients received less preventive care than male patients (65.2% vs. 72.1%, p<0.001). Female physicians provided significantly more preventive care than male physicians (p=0.01) to both female (66.7% vs. 63.6%) and male patients (73.4% vs. 70.7%). After multivariate adjustment, differences according to physician (p=0.02) and patient gender (p<0.001) remained statistically significant. Female physicians provided more recommended cancer screening than male physicians (78.4 vs. 71.9%, p=0.01).
  
  
  CONCLUSIONS
  In Swiss university primary care settings, female patients receive less preventive care than male patients, with female physicians providing more preventive care than male physicians. Greater attention should be paid to female patients in preventive care and to why female physicians tend to provide better preventive care.
authors.affiliation: Department of General Internal Medicine, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: Simone
authors.initials: S
authors.lastname: Krähenmann-Müller
authors.affiliation: Department of General Internal Medicine, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: Vanessa S
authors.initials: VS
authors.lastname: Virgini
authors.affiliation: Department of General Internal Medicine, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: Manuel R
authors.initials: MR
authors.lastname: Blum
authors.affiliation: Department of General Internal Medicine, Inselspital, University of Bern, Bern, Switzerland; CTU Bern, Department of Clinical Research and Institute of Social, and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
authors.forename: Bruno R
authors.initials: BR
authors.lastname: da Costa
authors.affiliation: Department for Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland; Service of Endocrinology, Diabetes, and Metabolism, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Tinh-Hai
authors.initials: TH
authors.lastname: Collet
authors.affiliation: Department for Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland.
authors.forename: Yonas
authors.initials: Y
authors.lastname: Martin
authors.affiliation: Department for Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland.
authors.forename: Jacques
authors.initials: J
authors.lastname: Cornuz
authors.affiliation: Division of Internal Medicine, University Hospital of Zürich, Zürich, Switzerland.
authors.forename: Lukas
authors.initials: L
authors.lastname: Zimmerli
authors.affiliation: Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Gaspoz
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA, United States.
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Bauer
authors.affiliation: Division of General Internal Medicine, Department of Medicine, School of Medicine, University of Michigan, MI, United States; Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, United States.
authors.forename: Eve A
authors.initials: EA
authors.lastname: Kerr
authors.affiliation: Department of General Internal Medicine, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: Drahomir
authors.initials: D
authors.lastname: Aujesky
authors.affiliation: Department of General Internal Medicine, Inselspital, University of Bern, Bern, Switzerland. Electronic address: Nicolas.Rodondi@insel.ch.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rodondi
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011314:Preventive Health Services / Q000592:standards*; D011320:Primary Health Care / Q000379:methods*; D012189:Retrospective Studies; D012737:Sex Factors; D013557:Switzerland
keywords: Patient physician gender concordance; Preventive care; Primary health care; Women's health