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Prior research, mostly from North America, suggests improved clinical outcomes for female patients treated by female physicians. Whether these findings apply in European healthcare systems and how underlying processes of care vary by sex remains unclear. This study aimed to assess whether in-hospital outcomes and processes of care differ by patient sex, physician sex or their interaction, in a European setting.
Retrospective cohort study.
General internal medicine division of a Swiss tertiary teaching hospital.
Adult inpatients (≥18 years) hospitalised between 2014 and 2024 and their primarily responsible physicians, classified by administrative sex (male vs female). The cohort included 20 094 hospitalisations (44.6% female patients) and 216 physicians (48.1% female).
Outcomes included in-hospital mortality, 30-day mortality and 30-day readmission, as well as processes of care (resource use, advance care planning and cardiovascular low-value care). Multilevel mixed-effects regression models adjusted for patient and physician characteristics.
Female patients had lower in-hospital mortality (OR 0.72, 95% CI 0.59 to 0.89) and 30-day mortality (OR 0.75, 95% CI 0.65 to 0.87), lower hospitalisation costs (–4.26%, 95% CI –6.08% to –2.41%), fewer diagnostic and therapeutic procedures (–6.44%, 95% CI –9.76% to –3.01%), fewer blood tests (–8.95%, 95% CI –12.98% to –4.73%) and were less likely to have resuscitation orders (OR 0.64, 95% CI 0.58 to 0.71) or intensive care unit transfer orders (OR 0.64, 95% CI 0.55 to 0.73). They were, however, more likely to receive non-indicated antihypertensive treatment (OR 1.86, 95% CI 1.38 to 2.51). No significant differences were observed by physician sex or patient–physician sex interaction.
In a European tertiary teaching hospital with universal healthcare coverage, in-hospital outcomes and processes of care did not differ by physician sex or patient–physician sex interaction. Nevertheless, disparities by patient sex persisted, underscoring the need for sex-disaggregated quality monitoring and sex-sensitive medical training.
To determine whether postponing daily medical rounds to provide additional preparation time for residents reduces round duration and alters time allocation during rounds, with the hypothesis that increased preparation leads to more efficient rounds without reducing patient contact.
Time and motion study with a before-and-after comparison.
Internal medicine division of Lausanne University Hospital, a Swiss tertiary teaching hospital.
75 residents; 60% women; mean age of 29.6 years and 3.0 years of training.
In 2017, the daily work schedule was reorganised by postponing rounds from 09:00 to 10:00 and moving educational sessions to the afternoon, thereby freeing 90 min to prepare patient cases before rounds.
The primary outcome was the duration of rounds and the proportion thereof spent with patients, using computer systems or in discussion with colleagues. Secondary outcomes included the detailed distribution of resident activities during the officially scheduled round period, particularly time dedicated to supervision, teaching and administrative tasks.
Round duration decreased from 142 min per shift (95% CI 128 to 156) in 2015 to 112 min (95% CI 101 to 124) in 2018 (p=0.001). The proportion of round time spent directly with patients remained stable at 47%. Computer use during rounds decreased from 43% to 32% (p
Postponing rounds to allow more preparation time was associated with shorter, possibly more efficient rounds, reduced computer use in patient presence and increased supervision and teaching.
ISRCTN69703381,
FreshRSS 