Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo.
Int Heart J. 2022;63(2):264-270. doi: 10.1536/ihj.21-451.
The cost and/or cost-effectiveness for inpatient management according to the gender of attending physicians remain to be elucidated.Hospitalization costs were extracted from the Diagnosis Procedure Combination (DPC) -based payment system. Using a dataset of 7,457 hospitalized patients with cardiovascular diseases in our hospital from 2012 to 2018, we compared the actual cost of inpatient management by female cardiologists with that by male cardiologists. Next, we estimated the cost-effectiveness of inpatient management according to the gender of the attending cardiologist. The cost of initial hospitalization per patient was similar between the patients treated by a female or male middle-grade cardiologist ($17,527 ± 14,158, versus $17,358 ± 15,183, P = 0.69). As an analysis on cost-effectiveness, the incremental cost of hospitalization managed by male middle-grade cardiologists was $67 per patient as compared with female middle-grade cardiologists. Concordantly, evaluation of the incremental cost-effectiveness ratio per quality-adjusted life year gained showed that the inpatient management by female cardiologists was dominant over that by male cardiologists.Inpatient management by female cardiologists was more cost-effective as compared with that by male cardiologists. Physician gender might have a considerable effect on medical economics.
根据主治医生的性别,住院管理的费用和/或成本效益仍有待阐明。住院费用是从按诊断相关分组(DPC)付费系统中提取的。我们使用了 2012 年至 2018 年我院 7457 名心血管疾病住院患者的数据集,比较了女性心脏病专家和男性心脏病专家管理住院患者的实际成本。接下来,我们根据主治心脏病专家的性别估算了住院管理的成本效益。女性或男性中级心脏病专家治疗的每位患者的初始住院费用相似($17,527 ± 14,158,与$17,358 ± 15,183,P = 0.69)。作为成本效益分析,与女性中级心脏病专家相比,男性中级心脏病专家管理住院的增量成本为每位患者$67。同样,每获得一个质量调整生命年的增量成本效益比的评估表明,女性心脏病专家的住院管理优于男性心脏病专家。与男性心脏病专家相比,女性心脏病专家的住院管理更具成本效益。医生的性别可能对医疗经济学有重大影响。