Observational studyBMJ open2019
Missing female patients: an observational analysis of sex ratio among outpatients in a referral tertiary care public hospital in India.
Observational study in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
52 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Stroke in India: A systematic review of the incidence, prevalence, and case fatality.International journal of stroke : official journal of the International Stroke Society · 2022Pooled it
- Gender-transformative action as a strategy for health system strengthening: a framework for advancing equity, accountability, and resilience.International journal for equity in health · 2026Article
- Bridging global diversity gaps in Parkinson disease research.Nature reviews. Neurology · 2026Review
- Global Perspectives in Plastic Surgery: View of Plastic Surgeons From India.Plastic and reconstructive surgery. Global open · 2026Article
- Article
- Trends and insights from healthcare utilization in a South Indian teaching institute: A retrospective analysis.Journal of family medicine and primary care · 2026Article
- Family medicine and primary care: Exigency to address in tertiary care institutions.Journal of family medicine and primary care · 2026Article
- Gender-based discrimination towards cisgender women in low- and middle-income countries: a scoping review of definitions and measures used in the health literature.BMJ public health · 2026Article
- A new approach for improving access to primary care and public health in India: the 3T Model.Health promotion perspectives · 2025Article
- Effect of Home-based Mobile Guided Pranayam and Yog Nidra Meditation on Blood Pressure and Sleep Quality of Elderly Hypertensive Individuals: A Randomised Controlled Trial.Annals of neurosciences · 2025Article
- Sex differences in disease burden, utilization, and expenditure on primary health care services in Kerala, India.Scientific reports · 2025Article
- Lack of sex bias in the referral letters for patients with inflammatory bowel disease: a mixed methods evaluation.Journal of the Canadian Association of Gastroenterology · 2025Article
- Health inequality and improvement gap in the prevalence of gynecological cancers among perimenopausal women globally, 1990-2019.BMC public health · 2025Article
- Article
- Impact of pandemic-related worries on mental health in India from 2020 to 2022.Npj mental health research · 2024Article
- The first genetically confirmed cohort of Facioscapulohumeral Muscular Dystrophy from Northern India.European journal of human genetics : EJHG · 2024Article
- Analysis of acute poisoning cases at a tertiary care hospital.Journal of family medicine and primary care · 2024Article
- A step closer towards achieving universal health coverage: the role of gender in enrolment in health insurance in India.BMC health services research · 2024Article
- The constrained-disorder principle defines the functions of systems in nature.Frontiers in network physiology · 2024Review
- Self-reported symptom burden among patients attending public health care facilities in India: Looking through ICPC-3 lens.PLOS global public health · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate gender discrimination in access to healthcare and its relationship with the patient's age and distance from the healthcare facility. DESIGN AND
settingAn observational study based on outpatient data from a large referral public hospital in Delhi, India.
participantsConfirmed clinical appointments. PRIMARY AND SECONDARY OUTCOME MEASURES: Estimates from the logistic regression are used to compute sex ratios (male/female) of patient visits with respect to distance from the hospital and age. Missing female patients for each state-a measure of the extent of gender discrimination-is computed as the difference in the actual number of female patients who came from each state and the number of female patients that should have visited the hospital had male and female patients come in the same proportion as the sex ratio of the overall population from the 2011 census.
resultsOf 2377028 outpatient visits, excluding obstetrics and gynaecology patients, the overall sex ratio was 1.69 male to one female visit. Sex ratios, adjusted for age and hospital department, increased with distance. The ratio was 1.41 for Delhi, where the facility is located; 1.70 for Haryana, an adjoining state; 1.98 for Uttar Pradesh, a state further away; and 2.37 for Bihar, the state furthest from Delhi. The sex ratios had a U-shaped relationship with age: 1.93 for 0-18 years, 2.01 for 19-30 years, and 1.75 for 60 years or over compared with 1.43 and 1.40 for the age groups 31-44 and 45-59 years, respectively. We estimate there were 402 722 missing female outpatient visits from these four states, which is 49% of the total female outpatient visits for these four states.
conclusionWe found gender discrimination in access to healthcare, which was worse for female patients who were in the younger and older age groups, and for those who lived at increasing distances from the hospital.
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