title: A Comprehensive Assessment of Family Physician Gender and Quality of Care: A Cross-Sectional Analysis in Ontario, Canada.
abstract: BACKGROUND
  Studies evaluating primary care quality across physician gender are limited to primary and secondary prevention.
  
  
  OBJECTIVE
  Investigate the relationship between family physician gender and quality of primary care using indicators that cover 5 key dimensions of primary care.
  
  
  METHODS
  Cross-sectional analysis using linked health administrative datasets (April 1, 2008 to March 31, 2010).
  
  
  METHODS
  All family physicians working in the 3 main primary care models in the province of Ontario (Canada), providing general care and having a panel size >1200.
  
  
  METHODS
  Indicators of cancer screening (3), chronic disease management (9), continuity (2), comprehensiveness (2), and access (5).
  
  
  RESULTS
  A total of 4195 physicians (31% female) were eligible. Adjusting for provider and patient factors, patients of female physicians were more likely to have received recommended cancer screening (odds ratios [95% confidence interval (CI)] (OR) range: 1.24 [1.18-1.30], 1.85 [1.78-1.92]) and diabetes management (OR: 1.04 [1.01-1.08], 1.28 [1.05-1.57]). They had fewer emergency room visits (rate ratio [95% CI] (RR) range: 0.83 [0.79-0.87]) and hospitalizations (RR: 0.89 [0.86-0.93]), and higher referrals (RR: 1.12 [1.09-1.14]). There was evidence of effect modification by patient gender (female vs. male) for hospitalization (RR: 0.74 [0.70-0.79] vs. 0.96 [0.90-1.02]) and emergency room visits (RR: 0.84 [0.81-0.88] vs. 0.98 [0.94-1.01]). Lower emergency room visits were also more evident in more complex patients of female physicians. There were no significant differences in the continuity or comprehensiveness measures.
  
  
  CONCLUSIONS
  The indicators assessed in this study point to a benefit for patients under the care of female physicians. Potential explanations are discussed.
authors.affiliation: *Department of Family Medicine, University of Ottawa †C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute ‡Institute of Population Health §Department of Epidemiology and Community Medicine, University of Ottawa ∥Institute of Clinical Evaluative Sciences, Ottawa ¶Queen's University, Kingston, ON, Canada #Southern Academic Primary Care Research Unit. School of Primary Health Care, Monash University, Clayton, Vic, Australia **Ottawa Hospital Research Institute ††Bruyère Family Medicine Centre, Ottawa, ON, Canada.
authors.forename: Simone
authors.initials: S
authors.lastname: Dahrouge
authors.forename: Emily
authors.initials: E
authors.lastname: Seale
authors.forename: William
authors.initials: W
authors.lastname: Hogg
authors.forename: Grant
authors.initials: G
authors.lastname: Russell
authors.forename: Jaime
authors.initials: J
authors.lastname: Younger
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Muggah
authors.forename: David
authors.initials: D
authors.lastname: Ponka
authors.forename: Jay
authors.initials: J
authors.lastname: Mercer
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002908:Chronic Disease / Q000628:therapy; D003266:Continuity of Patient Care / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010821:Physicians, Family / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D012017:Referral and Consultation; D012111:Residence Characteristics; D012737:Sex Factors; D012959:Socioeconomic Factors