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Is Physician Gender Associated With the Quality of Diabetes Care?

¹ Departments of Medicine and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
² Departments of Medicine and Epidemiology, University of Michigan, Ann Arbor, Michigan
³ Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia
⁴ Indiana University School of Medicine, Indianapolis, Indiana
⁵ Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
⁶ Division of Research, Kaiser Permanente, Oakland, California

Address correspondence and reprint requests to Catherine Kim, MD, MPH, Room 7C13, 300 NIB, Box 0429, Ann Arbor, MI 48109. E-mail: cathkim{at}umich.edu

OBJECTIVE—This study examines the association between physician gender and diabetes quality of care.

RESEARCH DESIGN AND METHODS—We examined the association between the gender of primary care physicians (n = 1,686) and the quality of diabetes care they provided to their patients participating in the Translating Research Into Action for Diabetes (TRIAD) study. Main outcome measures were diabetes processes of care including receipt of dilated retinal exams, urine microalbumin/protein testing, foot exams, lipid and HbA_1c (A1C) testing, recommendation to take aspirin, and influenza vaccination over 1 year. Intermediate outcomes included blood pressure, A1C, LDL levels, and patient satisfaction. Hierarchical regression models accounted for clustering within provider groups and health plans and adjusted for patient age, gender, race, income, education, diabetes treatment and duration, and health status, along with physician age, years of practice, and specialty.

RESULTS—Compared with male physicians (n = 1,213), female physicians (n = 473) were younger, had more recently completed training, and were more often internists. Patients of female physicians (n = 4,585) were more often women and younger than patients of male physicians (n = 1,783). In adjusted analyses, patients of female physicians were slightly more likely to receive lipid measurements (predicted probability 1.09 [95% CI 1.02–1.15]) and A1C measurements (1.02 [1.00–1.05]) and were slightly more likely to have an LDL <130 mg/dl (1.05 [1.00–1.10]).

CONCLUSIONS— Patients of female physicians received similar quality of care compared with patients of male physicians.

Abbreviations: PCP, primary care physician • TRIAD, Translating Research Into Action for Diabetes

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