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Women face bias over operations: Doctors are more likely to offer heart surgery to male patients, study finds

Celia Hall,Medical Editor
Thursday 29 April 1993 18:02 EDT
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FEMALE patients are being discriminated against by doctors and are offered fewer operations than men, particularly those suffering from heart disease, even though there is no obvious difference in their condition, according to a study.

Researchers found that heart specialists are much less likely to offer surgery to female patients, whatever their age at referral, even if their condition left them more disabled than men. The latest study also suggests that family doctors, too, may be less responsive to the needs of women with chest pains and be slower to refer them to specialist units for treatment.

The researchers found that male patients were one and a half times more likely to have bypass surgery or a balloon angioplasty to clear narrowed arteries, even though the female patients often suffered from more disability.

The results of an analysis of 23,707 patients seen at 13 hospitals in the south of England, will be published in tomorrow's edition of the British Medical Journal. Researchers discuss what had happened to the patients, all of whom had been referred to specialist units with coronary heart disease.

Dr Mark Petticrew, of the health services research unit at the London School of Hygiene and Tropical Medicine, says there is a 'systematic difference in the treatment received by men and women in the United Kingdom . . . despite their greater level of disability. This is consistent with a growing body of evidence from other areas of medicine, such as that on the treatment of chronic renal failure, and a British study that found that women wait longer for pacemaker implantation'.

Some studies have shown that because women may be referred later, they are consequently in a worse condition which could influence the specialists' decision on surgery.

Dr Petticrew said yesterday: 'We cannot really account for this. It may not be deliberate discrimination on behalf of the surgeons. It may be that women are more willing to make lifestyle changes. But we could find no clinical reasons for the difference in treatment.'

He and his colleages began their British study after American research had shown wide differences in how women were treated, compared to men. In the United States, women are 20 per cent less likely to be given dialysis for kidney disease and 50 per cent less likely to have a kidney transplant.

Deaths among women from respiratory disease rose by 7 per cent in 1991, to 32,453, according to the Office of Population Censuses and Surveys' study, Mortality Statistics, Cause, England & Wales 1991.

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