Physician-patient sex concordance and patient outcomes: Evidence from China

The growing body of research on the effects of physician-patient sex concordance on healthcare delivery across various medical settings has yielded highly heterogeneous results, with limited evidence from low- and middle-income countries (LMICs). This study aims to examine the impact of physician-patient sex concordance on both the quality of care (treatment outcomes and 30-day readmission rates) and medical expenditure (total expenditure and specific fee categories) among hospitalized patients with acute myocardial infarctions (AMI) in China. Using hospital administrative data (2018-2022) from a tertiary general hospital in Eastern China, we focus on the patients with a primary discharge diagnosis of AMI to achieve the random matching between physicians and patients (n = 1299). Our findings indicate that 70 % of AMI patients were treated by surgeons of the same sex. The patients in the physician-patient sex concordance group incurred significantly higher hospitalized expenditure, primarily in medication and surgery expenditure, with no significant increase in diagnostic expenditure. Physician-patient sex concordance was associated with an average increase of 2.3 days of hospitalization and a 4.37 percentage point increase in the copayment rate. However, no significant improvement in quality of care was observed. These findings provide a foundation for future research on the underlying mechanisms driving disparities in healthcare delivery due to physician-patient sex concordance, which is critical for the deep understanding of gender equity in health care.