Gender and Utilization of Ancillary Services

• Published in: Journal of general internal medicine : JGIM Vol. 13; no. 7; pp. 476 - 481
• Main Authors: Jha, Ashish K., Kuperman, Gilad J., Rittenberg, Eve, Bates, David W.
• Format: Journal Article
• Language: English
• Published: Cambridge, MA, USA Blackwell Science, Inc 01.07.1998; Springer; Springer Nature B.V; Blackwell Science Inc
• Subjects: ancillary services; Ancillary Services, Hospital - economics; Ancillary Services, Hospital - statistics & numerical data; Biological and medical sciences; Cardiovascular disease; Confounding Factors (Epidemiology); Diagnosis-Related Groups; Female; gender; Gender differences; General populations; Hemodialysis; Hospital Costs; Hospitalization; Hospitals; Humans; Internal medicine; Length of Stay; Male; Medical imaging; Medical laboratories; Medical sciences; Medicine; Multivariate Analysis; Obstetrics; Original; Patient admissions; Physicians; Prevention and actions; Primary care; Public health. Hygiene; Public health. Hygiene-occupational medicine; Retrospective Studies; Sex Factors; utilization; Womens health; Human; Public health organization; Laboratory investigations; Use; Sex; Radiology; Female; Influence; Hospitalization; Gender identity; Public health; Retrospective
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1046/j.1525-1497.1998.00137.x

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.