Fransoo Randall R, Martens Patricia J, Prior Heather J, Burland Elaine, Château Dan, Katz Alan
Research Scientist, Manitoba Centre for Health Policy, Assistant Professor, Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, MB.
Healthc Policy. 2010 Aug;6(1):88-103.
Many investigators have reported higher rates of cardiac procedures for males than females after acute myocardial infarction (AMI), suggesting that men are treated more aggressively than women. However, others have reported no significant differences after controlling for age, resulting in uncertainty about the existence of a true gender bias in cardiac care. In this study, a population-based cohort approach was used to calculate age-specific procedure rates by sex from administrative data. Chi-square tests and generalized linear modelling were used to assess gender differences and interactions. For all four procedures studied, rates were significantly higher for males than females (p<0.01). However, age-specific rates revealed few significant differences by gender and a sharp decrease in intervention rates with age for both males and females. Generalized linear modelling confirmed that patient age was a significant predictor of intervention rates, whereas sex was not. The significant gender difference in overall rates was completely confounded by the older age profile of female AMI patients compared to their male counterparts.
许多研究者报告称，急性心肌梗死（AMI）后男性接受心脏手术的比例高于女性，这表明男性比女性接受的治疗更为积极。然而，也有其他研究者报告称，在控制年龄因素后，两者并无显著差异，这使得心脏护理中是否存在真正的性别偏见存在不确定性。在本研究中，采用基于人群的队列研究方法，根据行政数据按性别计算特定年龄的手术率。使用卡方检验和广义线性模型来评估性别差异和相互作用。对于所研究的所有四种手术，男性的手术率均显著高于女性（p<0.01）。然而，特定年龄的手术率显示，性别差异不显著，且男性和女性的干预率均随年龄急剧下降。广义线性模型证实，患者年龄是干预率的重要预测因素，而性别则不是。与男性AMI患者相比，女性AMI患者年龄较大，这完全混淆了总体手术率中显著的性别差异。
