Cohen M, Ferrier B M, Woodward C A, Goldsmith C H
Faculty of Health Sciences, McMaster University.
J Am Med Womens Assoc (1972). 1991 Mar-Apr;46(2):49-54.
This study examined the extent to which physician gender influences practice patterns. Data came from the Ontario Hospital Insurance Plan billing profiles of general practitioner and family medicine graduates of McMaster University School of Medicine. The women physicians studied were more likely to be certified in family medicine than the men and a higher proportion of their patients were female. Women were more likely to be working part time, billed during fewer months of the year, earned less, and saw fewer patients. They provided greater numbers of services in psychotherapy and counselling and ordered more laboratory tests; associated with this were higher costs per service and per patient. Women offered a less diverse mix of services than men. They provided fewer hospital, emergency room, and intrapartum services and a lower proportion of women included house calls, after-hours work, hospital, emergency room, surgical or intrapartum services in their service mix. Thus these women appeared more likely to restrict their practices to the office setting and to provide a higher proportion of psychosocial care. The overall impact of these sex differences in practice patterns on the health care system requires further exploration.
本研究考察了医生性别对医疗行为模式的影响程度。数据来源于安大略省医疗保险计划中麦克马斯特大学医学院全科医生及家庭医学专业毕业生的账单资料。参与研究的女医生比男医生更有可能获得家庭医学专业认证，且她们的患者中女性比例更高。女性更有可能从事兼职工作，一年中计费的月份较少，收入较低，看诊的患者也较少。她们提供了更多的心理治疗和咨询服务，开出了更多的实验室检查单；与此相关的是每项服务和每位患者的成本更高。女性提供的服务种类比男性少。她们提供的住院、急诊和分娩期服务较少，在她们的服务组合中，提供上门服务、夜间工作、住院、急诊、手术或分娩期服务的女性比例较低。因此，这些女性似乎更有可能将其医疗行为局限于门诊环境，并提供更高比例的心理社会护理。这些医疗行为模式中的性别差异对医疗保健系统的总体影响需要进一步探讨。
