학술논문

The Association of Patient-Physician Gender Concordance with Cardiovascular Disease Risk Factor Control and Treatment in Diabetes
Document Type
article
Source
Journal of Women's Health. 18(12)
Subject
Cardiovascular
Diabetes
Clinical Research
Heart Disease
Prevention
7.1 Individual care needs
Management of diseases and conditions
Good Health and Well Being
Adult
Aged
Antihypertensive Agents
California
Cardiovascular Diseases
Causality
Comorbidity
Cross-Sectional Studies
Diabetes Mellitus
Type 2
Female
Humans
Hyperlipidemias
Hypertension
Hypolipidemic Agents
Male
Managed Care Programs
Middle Aged
Patient Compliance
Physician-Patient Relations
Physicians
Women
Practice Patterns
Physicians'
Quality Assurance
Health Care
Sex Factors
Treatment Outcome
Trust
Medical and Health Sciences
Public Health
Language
Abstract
BackgroundGender concordance between patients and their physicians is related to prevention screening and other quality indicators. Research suggests female physicians may place greater emphasis on preventive care than male physicians; however, little is known about whether physician gender and patient-physician gender concordance are associated with cardiovascular disease (CVD) risk factor levels and treatment. Our objective was to examine associations between patient gender, physician gender, and their interaction with CVD risk factor control, medication adherence, and treatment intensification in diabetes.MethodsIn this study, 157,458 Kaiser Permanente Northern California adult diabetes patients with a primary care physician (PCP) were assessed for above target levels of hemoglobin A1c (HbA1c) (>or=8%), low-density lipoprotein cholesterol (LDL-C) (>or=100 mg/dL), and systolic blood pressure (SBP>or=130 mm Hg) in 2005. Medication adherence and appropriate CVD treatment intensification were assessed using pharmacy data. Probit models assessed the adjusted marginal effects of patient gender, PCP gender, and their interaction on control, adherence, and intensification.ResultsFemale patients had lower adjusted rates of LDL-C (46% vs. 55%, p