Gender Difference In Outcomes In Acute Medicine: Women Of Lower Socio-Economic Status Have Worse Outcomes
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Background: There are data that suggest that women hospitalised for a variety of medical conditions may have worse outcomes than men; there is a paucity of literature on hospital mortality outcome by gender and Socio-Economic status (SES) for unselected admissions.
Methods: Emergency medical admissions between 2002 and 2018 were examined. We assessed 30-day in-hospital mortality, by gender and SES, using logistic regression and margins statistics modelled outcomes against predictor variables.
Results: There were 113,807 episodes in 58,126 patients over the period, with known SES status. There were multiple admissions per patient; only 45.4% had a single admission with the percentage of patients with 1, 2, or 3 at 18.8%, 10.4% and 6.5%, respectively. The average per patient 30-day in-hospital mortality was 11.1% (95%CI:10.6%, 11.6%) for males and 11.0% (95%CI:10.5%, 11.6%) females (p = 0.84). Males from higher, 12.2% (95%CI:10.6%, 13.8%), or lower SES small areas, 12.6% (95%CI: 12.1%, 13.1%), had equivalent 30-day mortality outcomes. Females from higher SES had significantly better outcomes compared with females from lower SES small areas- 9.4% (95% CI:8.0%, 10.8%) versus 12.7% (95%CI:12.2%,13.2%).
Conclusion: 30-day in-hospital mortality adjusted for outcome predictors were similar for males and females; however, whereas the model-adjusted mortality for males was not different across SES, females of lower SES had significantly worse outcomes than those of higher SES.
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