Gender Differences in Patient‐Reported Outcomes Among Adults With Atherosclerotic Cardiovascular Disease

Author:

Okunrintemi Victor1,Valero‐Elizondo Javier2,Patrick Benjamin3,Salami Joseph4,Tibuakuu Martin56,Ahmad Saba7,Ogunmoroti Oluseye6,Mahajan Shiwani2,Khan Safi U.8,Gulati Martha9,Nasir Khurram210,Michos Erin D.611

Affiliation:

1. Department of Internal Medicine East Carolina University Greenville NC

2. Center for Outcomes Research and Evaluation Yale New Haven Hospital New Haven CT

3. State House Annex Clinic Abuja Nigeria

4. Baptist Health South Florida Miami FL

5. Department of Medicine St. Luke's Hospital Chesterfield MO

6. Ciccarone Center for the Prevention of Cardiovascular Disease Johns Hopkins School of Medicine Baltimore MD

7. Department of Cardiology Lankenau Medical Center Wynnewood PA

8. West Virginia University Morgantown WV

9. Division of Cardiology University of Arizona College of Medicine Phoenix AZ

10. Division of Cardiology Yale School of Medicine New Haven CT

11. Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD

Abstract

Background Atherosclerotic cardiovascular disease ( ASCVD ) accounts for approximately one third of deaths in women. Although there is an established relationship between positive patient experiences, health‐related quality of life, and improved health outcomes, little is known about gender differences in patient‐reported outcomes among ASCVD patients. We therefore compared gender differences in patient‐centered outcomes among individuals with ASCVD . Methods and Results Data from the 2006 to 2015 Medical Expenditure Panel Survey, a nationally representative US sample, were used for this study. Adults ≥18 years with a diagnosis of ASCVD , ascertained by International Classification of Diseases, Ninth Revision ( ICD‐9) codes and/or self‐reported data, were included. Linear and logistic regression were used to compare self‐reported patient experience, perception of health, and health‐related quality of life by gender. Models adjusted for demographics, socioeconomic status, and comorbidities. There were 21 353 participants included, with >10 000 (47%‐weighted) of the participants being women, representing ≈11 million female adults with ASCVD nationwide. Compared with men, women with ASCVD were more likely to experience poor patient–provider communication (odds ratio 1.25 [95% confidence interval 1.11–1.41]), lower healthcare satisfaction (1.12 [1.02–1.24]), poor perception of health status (1.15 [1.04–1.28]), and lower health‐related quality of life scores. Women with ASCVD also had lower use of aspirin and statins, and greater odds of ≥2 Emergency Department visits/y. Conclusions Women with ASCVD were more likely to report poorer patient experience, lower health‐related quality of life, and poorer perception of their health when compared with men. These findings have important public health implications and require more research towards understanding the gender‐specific differences in healthcare quality, delivery, and ultimately health outcomes among individuals with ASCVD .

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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