More male patients than female patients at AIIMS New Delhi point to deep gender imbalances in healthcare

From education to work opportunities and political participation, Indian women face discrimination in almost every aspect of life. Now, data confirm something we’ve known all along: women also have poorer access to healthcare across the country.

A recent study with 2.37 million patients in the outpatient department of All India Institute of Medical Sciences or AIIMS in New Delhi, found a male to female ratio of 1.69:1 — for every 169 males, there were only 100 female patients — if you exclude the gynaecology and obstetrics department.

The study, ‘Missing female patients: an observational analysis of sex ratio among outpatients in a referral tertiary care public hospital in India’, was published in the British Medical Journal, a weekly peer-reviewed journal.

Deeper insight

AIIMS Delhi gets patients from all over the country. Plus, it has more facilities and a better standard of patient care than local clinics and hospitals across the country.

In the paper, Mudit Kapoor, lead author and associate professor of economics at the Indian Statistical Institute, wrote: females in the older and younger age groups are much less likely to visit a hospital compared with women in the middle-age group. “Though they may be visiting their local health facility, there is a huge gap between the quality of care in premium public institutions such as AIIMS and local public health facilities,” he added.

The study also found that the gender skew towards male patients grew with increasing distance from the hospital. Statewise, the gender gap was 141 male per 100 female patients from Delhi, 170 to 100 from Haryana, 198 to 100 from Uttar Pradesh and 237 to 100 from Bihar.

The government of India has already listed Bihar and Uttar Pradesh as the states with the least access to tertiary healthcare facilities, with less than 50% of the required doctors in Bihar.

More context

This is not the first study to assess gender disparity in healthcare in India. Irrespective of their sample size and area, most studies find that male children and men get better quality healthcare in households across India. According to one such study, a male child is 3.5 times more likely to get corrective treatment for congenital heart defects than a female child. Similar trends have been noticed in older adults undergoing heart surgeries like angioplasty or myocardial infarction.

Of course, poverty and patriarchal lineage have a role to play in determining access to tertiary healthcare.

“The strength of this paper,” Kapoor wrote, “is the huge number of outpatient visits available for analysis… Being a large hospital with over two million patients it has a huge referral base from various states in India.”

Kapoor also addressed a potential critique of the study: men are anyway more likely to have diseases like cardiovascular disease. Higher risk of the disease in men would mean more male patients and greater representation in the set. However, Kapoor wrote that because the study takes into account so many diseases across departments, this is enough to balance out any miscalculations due to disease infliction.

This study is yet another proof that gender bias and healthcare access still remain a major concern - despite the many programmes run by the Central and state governments to extend health services to women.

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