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

被引:76
|
作者
Okunrintemi, Victor [1 ]
Valero-Elizondo, Javier [2 ]
Patrick, Benjamin [3 ]
Salami, Joseph [4 ]
Tibuakuu, Martin [5 ,6 ]
Ahmad, Saba [7 ]
Ogunmoroti, Oluseye [6 ]
Mahajan, Shiwani [2 ]
Khan, Safi U. [8 ]
Gulati, Martha [9 ]
Nasir, Khurram [2 ,10 ]
Michos, Erin D. [6 ,11 ]
机构
[1] East Carolina Univ, Dept Internal Med, Greenville, NC 27858 USA
[2] Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, 20 York St, New Haven, CT 06504 USA
[3] State House Annex Clin, Abuja, Nigeria
[4] Baptist Hlth South Florida, Miami, FL USA
[5] St Lukes Hosp, Dept Med, Chesterfield, MO USA
[6] Johns Hopkins Sch Med, Ciccarone Ctr Prevent Cardiovasc Dis, Baltimore, MD USA
[7] Lankenau Med Ctr, Dept Cardiol, Wynnewood, PA USA
[8] West Virginia Univ, Morgantown, WV USA
[9] Univ Arizona, Div Cardiol, Coll Med, Phoenix, AZ USA
[10] Yale Sch Med, Div Cardiol, New Haven, CT USA
[11] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA
来源
关键词
cardiovascular disease; health outcomes; health-related quality of life; secondary prevention; women; CORONARY-HEART-DISEASE; ACUTE MYOCARDIAL-INFARCTION; PRIMARY-CARE OUTCOMES; QUALITY-OF-LIFE; SEX-DIFFERENCES; PHYSICIAN GENDER; YOUNG-PATIENTS; HEALTH-CARE; CENTERED COMMUNICATION; CARDIAC REHABILITATION;
D O I
10.1161/JAHA.118.010498
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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 approximate to 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.
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