Diagnostic Testing and Hospital Admission Rate Differences Between Female and Male Emergency Physicians

Article Impact Level: HIGH
Data Quality: STRONG
Summary of  JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2026.3110  
Dr. Dan P. Ly  et al.

Points

A comprehensive UCLA Health study analyzed over 1.5 million emergency department visits across Veterans Affairs facilities to examine practice pattern variations between female and male physicians.
Research findings revealed that female emergency physicians ordered 3% to 5% more laboratory and imaging diagnostic tests than male counterparts practicing in the same clinical settings.
Hospital admission rates were 3% to 5% higher among female physicians, though patients did not experience higher rates of short, potentially unnecessary hospital stays.
Patient mortality rates showed no statistical difference between male and female providers, suggesting additional testing reflected distinct approaches to managing clinical diagnostic uncertainty.
Investigators concluded that physician practice variations highlight the need to study risk aversion, diagnostic thoroughness, and long-term quality of life metrics beyond simple mortality outcomes.

Summary

This study evaluated physician sex-based practice pattern variations in diagnostic resource utilization, hospital admission rates, and short-term patient mortality within acute care settings. While prior literature demonstrated that female primary care physicians order more diagnostic testing and deliver higher rates of guideline-concordant care, evidence regarding practice variation in unselected acute care environments remains limited. The research investigated whether observed practice differences reflect unnecessary low-value care or distinct clinical approaches to diagnostic uncertainty among emergency department (ED) providers.

Using a comprehensive US Department of Veterans Affairs (VA) health system database, researchers conducted a retrospective analysis of more than 1.5 million emergency department visits. The study compared clinical practice patterns between female and male physicians working within identical ED environments to control for institutional factors and patient selection bias. Primary endpoints included the volume of laboratory and imaging diagnostic testing ordered, rates of inpatient hospital admission, proportion of short inpatient stays (a proxy metric for low-value hospitalizations), and overall patient mortality outcomes.

The analysis demonstrated that female physicians ordered 3% to 5% more laboratory and imaging diagnostic tests and admitted 3% to 5% more patients to the hospital compared to their male counterparts within the same clinical facilities. Crucially, hospitalized patients managed by female physicians showed no significant increase in short inpatient stays, indicating that additional admissions were clinically warranted rather than unnecessary. Furthermore, while the increased diagnostic testing and admission rates were not associated with significant differences in short-term patient mortality rates, the findings suggest distinct gender-based management strategies for addressing clinical risk and diagnostic uncertainty.

Link to the article: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2851436

References

Ly, D. P., Coussens, S., & Burke, L. G. (2026). Practice pattern and outcome differences in the emergency department by physician sex. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2026.3110