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Sex differences in use of interventional cardiology persist after risk adjustment
  1. Nicola Nante1,
  2. Gabriele Messina1,
  3. Michele Cecchini1,
  4. Oscar Bertetto2,
  5. Fulvio Moirano3,
  6. Martin McKee4
  1. 1 Health Services Research Laboratory, University of Sienna, Italy;
  2. 2 Regional Agency for Health Services of Piedmont, Italy;
  3. 3 Local Health Agency, Cuneo, Mondovì and Savigliano, Italy;
  4. 4 European Centre on Health of Societies, Italy
  1. E-mail: nante{at}unisi.it

Abstract

Introduction: Studies from several countries have documented gender disparities in the management of coronary artery disease. We ask whether such gender disparities are seen in Italy and, if so, whether they can be explained by factors such as age and severity of illness.

Methods: 77,974 Piedmontese patients, admitted between 1999 and 2002, with a primary diagnosis of myocardial infarction (ICD 410), angina (ICD 413), chronic ischaemia (ICD 414) and chest pain (ICD 786.5) were studied. The number of males and females undergoing surgical treatment was extracted and the male-female odds ratios calculated. Several risk factors and a risk adjustment technique (APR-DRG) were used to control for possible confounders. Backward stepwise multiple logistic regression was used to adjust for significant covariates.

Results: Crude analysis demonstrated that gender is a discriminating factor in the probability of surgery (OR=2.11, CI 2.04-2.19), with similar findings among those with each main diagnosis. The odds ratios decreased after adjustment for age, co-morbidity, and disease severity but remained significant.

Discussion: Males and females admitted to hospitals in a region of northern Italy with a diagnosis of cardiovascular disease are treated differently and this cannot be explained by age or severity of disease.

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