Si Yafei, Chen Gang, Su Min, Zhou Zhongliang, Yip Winnie, Chen Xi
School of Risk & Actuarial Studies, University of New South Wales, Australia.
ARC Centre of Excellence in Population Ageing Research (CEPAR), University of New South Wales, Australia.
medRxiv. 2023 Oct 5:2023.10.03.23296202. doi: 10.1101/2023.10.03.23296202.
Despite growing evidence of gender disparities in healthcare utilization and health outcomes, there is a lack of understanding of what may drive such differences. Designing and implementing an experiment using the standardized patients' approach, we present novel evidence on the impact of physician-patient gender match on healthcare quality in a primary care setting in China. We find that, compared with female physicians treating female patients, the combination of female physicians treating male patients resulted in a 23.0 percentage-point increase in correct diagnosis and a 19.4 percentage-point increase in correct drug prescriptions. Despite these substantial gains in healthcare quality, there was no significant increase in medical costs and time investment. Our analyses suggest that the gains in healthcare quality were mainly attributed to better physician-patient communications, but not the presence of more clinical information. This paper has policy implications in that improving patient centeredness and incentivizing physicians' efforts in consultation (as opposed to treatment) can lead to significant gains in the quality of healthcare with modest costs, while reducing gender differences in care.
尽管有越来越多的证据表明在医疗保健利用和健康结果方面存在性别差异,但对于可能导致这些差异的原因仍缺乏了解。通过采用标准化患者方法设计并实施一项实验,我们提供了关于医患性别匹配对中国基层医疗环境中医疗质量影响的新证据。我们发现,与女医生治疗女患者相比,女医生治疗男患者的组合使正确诊断率提高了23.0个百分点,正确药物处方率提高了19.4个百分点。尽管医疗质量有了这些显著提高,但医疗成本和时间投入并没有显著增加。我们的分析表明,医疗质量的提高主要归因于更好的医患沟通,而不是更多临床信息的存在。本文具有政策意义,即提高以患者为中心的程度并激励医生在咨询(而非治疗)方面的努力,可以在成本适度的情况下显著提高医疗质量,同时减少医疗保健中的性别差异。