Gender and Utilization of Ancillary Services

OBJECTIVE: To determine whether gender is associated with the use of ancillary services in hospitalized patients. DESIGN: A retrospective study of laboratory and radiology tests ordered for medical and surgical inpatients over 16‐month and 20‐month periods, respectively. Obstetric patients were excluded. MEASUREMENTS AND MAIN RESULTS: Number of clinical laboratory and radiology tests per admission, their associated charges, and total charges per admission were measured. In crude analyses, women had 16.5% fewer clinical laboratory tests ( p < .0001) with 18.8% lower associated charges ( p < .0001) and 24.4% fewer radiology tests ( p < .0001) with 15.6% lower associated charges ( p < .0001) than men. Total changes for the admission were lower for women in both the clinical laboratory study period ($16,178 vs $18,912, p < .0001) and the radiology study period ($14,621 vs $18,182, p < .0001). When adjusted for age, race, insurance status, service, diagnosis‐related‐group weight, and length of stay, these differences were smaller but persisted: women had 3.7% fewer laboratory tests performed ( p < .001) with 4.8% lower associated charges ( p < .001). In similarly adjusted analyses for radiology studies, women received 10.4% fewer radiology examinations ( p < .001), with 4.1% lower associated charges ( p < .01). There were no significant differences in the adjusted total charges in the laboratory group ($17,450 vs $17,655, p = .20) and only a marginally significant difference in the radiology group ($16,278 vs $16,498, p = .05). When we compared ancillary utilization within the five largest diagnosis‐related groups, these differences persisted. CONCLUSIONS: Men receive more ancillary services than women, even after adjusting for potential confounders.