Association of surgeon's sex, and surgeon‐patient dyad with financial outcomes among patients undergoing cancer surgery

Abstract

AbstractBackground and ObjectivesSurgeon sex has been associated with perioperative clinical outcomes among patients undergoing oncologic surgery. There may be variations in financial outcomes relative to the surgeon‐patient dyad. We sought to define the association of surgeon's sex with perioperative financial outcomes following cancer surgery.MethodsPatients who underwent resection of lung, breast, hepato‐pancreato‐biliary (HPB), or colorectal cancer between 2014 and 2021 were identified from the Medicare Standard Analytic Files. A generalized linear model with gamma regression was utilized to characterize the association between sex concordance and expenditures.ResultsAmong 207,935 Medicare beneficiaries (breast: n = 14,753, 7.1%, lung: n = 59,644, 28.7%, HPB: n = 23,400, 11.3%, colorectal: n = 110,118, 53.0%), 87.8% (n = 182,643) and 12.2% (n = 25,292) of patients were treated by male and female surgeons, respectively. On multivariable analysis, female surgeon sex was associated with slightly reduced index expenditures (mean difference ‐$353, 95%CI ‐$580, ‐$126; p = 0.003). However, there were no differences in 90‐day post‐discharge inpatient (mean difference ‐$−225, 95%CI ‐$570, ‐$121; p = 0.205) and total expenditures (mean difference $133, 95%CI ‐$279, $545; p = 0.525).ConclusionsThere was minor risk‐adjusted variation in perioperative expenditures relative to surgeon sex. To improve perioperative financial outcomes, a diverse surgical workforce with respect to patient and surgeon sex is warranted.