Abstract 16882: Practitioner Gender and Quality of Care in Ambulatory Cardiology Practices: A Report from the NCDR

Abstract

Background: Some studies have suggested female physicians are more likely than male physicians to provide guideline-concordant care; however little is known about the role of practitioner gender in cardiology. We measured the association between practitioner gender and adherence to the cardiovascular performance measures within the American College of Cardiology's ambulatory PINNACLE (Practice Innovation and Clinical Excellence) registry®

Methods: Patients with ≥1 outpatient visits with a unique male or female provider were included. Among eligible patients, adherence to 7 guideline-supported performance measures related to medical therapy for coronary artery disease (CAD), heart failure, and atrial fibrillation over 12 months after registry entry was compared by provider gender using hierarchical models adjusting for provider type (physicians vs. non-physician providers).

Results: A total of 454,551 patients were seen by 1096 individual practitioners; 80.4% of practitioners were men. The mean number of visits over 12 months with male and female practitioners was clinically similar (2 ± 1.3 vs.1.9 ± 1.3, p<0.01). More male practitioners were physicians (98.3% vs. 43.7%, p<0.01). After adjustment for provider type, female practitioners showed similar adherence rates for all measures with the exception of slightly lower rates for antiplatelet (69.6% vs. 73.9%, RR=0.96, 95% CI: 0.93-0.99, p= 0.01) and lipid-lowering therapy in CAD (90.3% vs. 93.1%, RR=0.99, 95% CI: 0.98-1.00, p=0.01) (table 1). Adherence rates were highest among both provider genders for ACEI/ARB and beta blocker use in patients with systolic dysfunction and lowest for warfarin use in atrial fibrillation.

Conclusions: Male and female practitioners generally performed comparably in ambulatory cardiology practices within this national registry. However, overall adherence to performance measures suggests room for improvement among all practitioners.