Provider Gender and Patient Outcomes: Exploring the Relationship
Patients often have preferences about healthcare providers, including psychiatrists. For example, personal or cultural experiences may lead a patient to feel more at ease with female providers, they may be more comfortable with a provider of the same gender, or they may have no preference at all. However, patients usually don’t choose their psychiatrist in hospital settings, and previous studies in other specialties have shown small associations between female physicians and lower chances of complications or even death [1] Understanding differences in the inpatient behavioral health setting could impact how we generally think about gender dynamics in mental healthcare.
MHO’s dataset from 2023-2024 contains 518 male providers and 213 female providers who each treated at least 100 adult inpatients (nearly 600,000 patients in all). Four psychiatrist/patient dyads were compared across multiple outcomes metrics:
- female psychiatrist – female patient
- female psychiatrist – male patient
- male psychiatrist – female patient
- male psychiatrist – male patient
Key findings
Length of Stay: No Meaningful Differences. Patients treated by male providers had a slightly longer length of stay – half a day more on average. However, dyads had no difference in median length of stay.
Readmission Rates: No Differences. Groups did not significantly differ in 30 day readmission rate, nor the average number of days until the readmission.
Clinical Outcomes: Similar Improvements Across the Board. Clinical outcomes were measured by admission severity, discharge severity, and admission-to-discharge Statistically Meaningful Improvement (SMI)[i] on two patient self-report clinical measures: patient functioning (BASIS-32™)[ii] and depression (PHQ-9)[iii]. Patients displayed similar level of symptom severity both at admission and discharge. Additionally, there were no differences in percent of patients achieving Statistically Meaningful Improvement from admission to discharge.
Patient Satisfaction with Provider: No Differences. Our findings showed no meaningful difference in how patients rated their experiences with male versus female providers.
Does gender really matter?
Our data suggest not in a material way. Given more than 2 in 3 providers in these data are male, it is encouraging to find provider gender is unlikely to drive differences in the patient experience. Ultimately, data suggest other factors such as provider skill and expertise – regardless of gender – contribute to successful patient outcomes in psychiatric care.
Figure 1. Provider Gender and Patient Outcomes Metrics (Interactive Graph)
References
[1] Miyawaki, A., Jena, A. B., Rotenstein, L. S., & Tsugawa, Y. (2024). Comparison of hospital mortality and readmission rates by physician and patient sex. Annals of Internal Medicine, 177(5), 598–608. https://doi.org/10.7326/m23-3163
Footnotes
[i] Note: SMI refers to a metric used to determine the degree of statistical change from admission to discharge. Based on the amount of change, patients are categorized into one of five SMI categories: Large improvement, small improvement, no effect, small decline, or large decline.
[ii] BASIS-32: The Behavior and Symptom Identification Scale is a self-report measure of a patient’s functioning, rated on a scale of 0 “no difficulties” to 4 “extreme difficulties”. BASIS-32 © Mclean Hospital, used by licensee with permission from Mclean Hospital.
[iii] PHQ-9: The Patient Health Questionnaire is a self-report measure of a patient’s depression, rated on a Scale of 0 “Not at all” to 3 “Nearly every day”. Developed by Drs. Robert L. Spitzer, Janet B. W. Wiliams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc.
