MAYBE WE HAVEN'T COME SO FAR AFTER ALL

ARTICLE COURTESY OF THE TORONTO STAR

Women 50 and older less likely to be admitted

Nov 15, 2007 04:30

AM Noor Javed Staff Reporter

Women 50 and older in need of critical care are less likely than men to be admitted to the intensive care unit or receive crucial life-supporting treatments in hospitals across the province, according to the findings of a new study.
The study, to be published in the Canadian Medical Association Journal next month, is just one of a number of recent articles that have indicated an inherent gender-bias exists in the health-care system, and may be putting elderly women at a disadvantage when it comes to treatment options – often with fatal consequences.
"It seems from our study that for some reason women are less likely to be offered or accept aggressive life-supporting care including critical care in an ICU, and may be more likely to die after becoming really sick in hospital than are men," said Dr. Robert Fowler, lead author of the study.
The two-year study assessed 466,792 patients who were consecutively admitted to 13 hospitals across the province in 2001 and 2002. They found that although more women were admitted to hospital than males overall, fewer women were admitted to ICU, even if their illness warranted such a move. The difference appeared to be even more pronounced among women 50 and older, who were 32 per cent less likely than men to be admitted to the ICU.
The study also showed that women were less likely to receive crucial treatments, such as mechanical ventilation while in ICU. Such discrepancies could be why the researchers found that women aged 50 were 1.2 times more likely to die while in ICU then men.
While past research in other areas of medicine, such as in cardiovascular care and joint-replacement therapy, has also pointed to gender-based differences in treatment, Fowler said he didn't expect to see it for life-altering decisions.
While the extensive study provides evidence that the problem exists, Fowler admits it doesn't offer solutions. "It's hard to know if the decision-making differences are on the basis of patient, their surrogate decision makers, or potentially the health-care team."
Fowler, a critical care physician at Sunnybrook Health Sciences Centre and researcher at the University of Toronto, is planning follow-up research to address the biases.