Gender and utilization of ancillary services

Jha, Ashish K.; Kuperman, Gilad J.; Rittenberg, Eve; Bates, David W.; Bates; Jha, A K; Kuperman, G J; Rittenberg, E; Bates, D W
July 1998
JGIM: Journal of General Internal Medicine;Jul1988, Vol. 13 Issue 7, p476
Academic Journal
journal article
Objective: To determine whether gender is associated with the use of ancillary services in hospitalized patients.Design: A retrospective study of laboratory and radiology tests ordered for medical and surgical inpatients over 16-month and 20-month periods, respectively. Obstetric patients were excluded.Measurements and Main Results: Number of clinical laboratory and radiology tests per admission, their associated charges, and total charges per admission were measured. In crude analyses, women had 16.5% fewer clinical laboratory tests (p < .0001) with 18.8% lower associated charges (p < .0001) and 24.4% fewer radiology tests (p < .0001) with 15.6% lower associated charges (p < .0001) than men. Total changes for the admission were lower for women in both the clinical laboratory study period ($16,178 vs $18,912, p < .0001) and the radiology study period ($14,621 vs $18,182, p < .0001). When adjusted for age, race, insurance status, service, diagnosis-related-group weight, and length of stay, these differences were smaller but persisted: women had 3.7% fewer laboratory tests performed (p < .001) with 4.8% lower associated charges (p < .001). In similarly adjusted analyses for radiology studies, women received 10.4% fewer radiology examinations (p < .001), with 4.1% lower associated charges (p < .01). There were no significant differences in the adjusted total charges in the laboratory group ($17,450 vs $17,655, p = .20) and only a marginally significant difference in the radiology group ($16,278 vs $16,498, p = .05). When we compared ancillary utilization within the five largest diagnosis-related groups, these differences persisted.Conclusions: Men receive more ancillary services than women, even after adjusting for potential confounders.


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