Women are less likely than men to receive care in a trauma center after severe injury, according to a new study of almost 100,000 Canadian patients.
"Gender-based disparities in access to healthcare services in general have been recognized for some time and evidence is emerging that these disparities extend to the treatment of severe injuries in trauma centers," says lead author Andrea Hill. MSc, PhD, a post-doctoral fellow at Sunnybrook Health Sciences Centre and the University of Toronto in Ontario, Canada. "Our study confirms and expands on these earlier findings by evaluating the relationship between gender and trauma center care in a large cohort of patients from across Canada."
The study results will be presented at the ATS 2013 International Conference in Philadelphia.
The retrospective cohort study included 98,871 adult patients with severe injury (Injury Severity Score>15 or death within 24 hours of hospital admission).
Of the 33,080 women in the cohort, 49.6% received care in a trauma center, compared to 63.2% of males, a statistically significant (p<0.0001) difference. In the subgroup of patients aged 65 or older, 37.5% of women received trauma center care, compared with 49.6% of men, again a significant (p<0.0001) difference.
After adjusting for the effects of clinical, demographic, and socioeconomic variables, severely injured womenremained less likely to be treated in a traumacenter than men (odds ratio 0.79, 95% confidence interval 0.76 - 0.82). Separate analyses of women with fall-related injuries and women with motor vehicle-related injuries revealed that they were also less likely to receive trauma center care than men.
This pattern of gender differences in access to trauma center care was consistent across different mechanisms of injury, different income levels and among both urban and rural patients.
"Our study provides yet more evidence of important gender differences in access to trauma center care for people with severe injuries," said Dr. Hill. "Future research should focus on the factors underlying these differences and on the effects of these disparities on patient outcomes."