Study Reveals Disparities in Heart Surgery Care for Women Over 65

According to a July 10 press release, a Michigan Medicine study found that women over the age of 65 who require complex heart surgery are more likely than men to receive care at low quality hospitals. They also die in greater numbers following the procedure.

The research is published in JAMA Network Open and studied nearly 450,000 Medicare beneficiaries who underwent coronary artery bypass grafting, or heart bypass surgery, between late 2015 and early 2020.

The press release states that “Compared to men, women were 1.26 times more likely to be treated at low quality hospitals, meaning facilities with the highest 30-day mortality rates.

“At those low-quality hospitals, women died in 7% of overall cases while men died nearly 5% of the time. The sex disparity in mortality doubled from high quality to low quality hospitals.”

“Nationwide, women are both more likely to die after heart bypass surgery and more likely to undergo surgery at low quality hospitals,” said Catherine M. Wagner, M.D., M.Sc., first author and integrated thoracic surgery resident at University of Michigan Health.

Women more commonly had unplanned admissions before coronary artery bypass grafting and “a higher comorbid conditions than men,” according to the study. Prior findings found that female patients with coronary artery disease are referred later for surgery, which this study supports.

Researchers suggest that he late presentation to the hospital may be due to the understudied biological differences between male and female patients.

“Additionally, higher quality hospitals that take on a greater volume of CABG cases each year have demonstrated better surgical outcomes for moderate to high risk cases,” the press release comments.

The study was supported by the University of Michigan Institute for Healthcare Policy and Innovation.