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Evaluation & the Health Professions
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Gender and Hospital Resource Use

Unexpected Differences

Annette M. Bernard

Emory University School of Medicine

Rodney A. Hayward

Judith S. Rosevear

Laurence F. McMahon, Jr.

University of Michigan Medical Center

Several recent studies have explored gender differences in medical care that are not attributable to clinical characteristics. At an 880bed teaching hospital between July 1987 and June 1990, we studied the importance of gender on two measures of hospital care: length of stay and ancillary service use. The latter was measured on a relative value unit (RVU) scale, based on an estimation of direct cost dollars. Neither mean age nor in-hospital mortality differed between the 9,102 women and 10,285 men. After case-mix adjustment, women stayed in the hospital 0.22 days longer than men (p = 0.01) but consumed 67fewer RVUs (p = 0.01). This RVU difference dissolved when intensive care unit (ICU) stays were eliminated; men were 1.13 times more likely (95% confidence interval 1.07 to 1.19) to be placed in the ICU. Being married shortened length of stay and women were less likely to be married (51% vs. 68%; p < 0.001), but even within marital status subgroups women remained in the hospital longer than men. Whether this longer length of stay and less technologically intensive care for women reflects a difference in illness severity or physician gender bias requires further study.

Evaluation & the Health Professions, Vol. 16, No. 2, 177-189 (1993)
DOI: 10.1177/016327879301600203
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