Skip to main content

Gender Differences in Patients’ Experience of Care in the Emergency Department


The emergency department (ED) is a unique healthcare environment, bridging outpatient and inpatient care. Previous work has reported gender differences in diagnosis and treatment in ED settings.1 However, little is known about gender differences in patient experience in the ED, though such differences are reported in other settings. Among patients discharged from acute care hospitals, women reported worse experiences than men on nine out of ten measures;2 in a study of Medicare Advantage enrollees, women reported better experiences than men on measures involving interactions with administrative staff and timely access to care, but worse experiences than men on getting needed care.3

Potential gender differences in ED patient experiences would run counter to recent calls for health equity. Such differences are also important given evidence that better patient experience is associated with better outcomes and better adherence to treatment recommendations.4 We used data from a nationwide study of ED patients to examine gender differences in patient-reported experiences with ED care.


We analyzed survey data from a nationwide administration of the Emergency Department Patient Experience of Care Discharged to Community survey (which became the ED CAHPS® Survey in March 2020) for ED patients discharged home between January and March 2016. Details regarding the survey instrument, study design, sampling, and item scoring are available elsewhere.5,6 Our analytic sample included 3122 eligible survey respondents from 50 hospitals. Gender was characterized as male vs. female and obtained from hospital administrative data. We analyzed eight patient experience measures scored to reflect the percentage of respondents who selected the most positive response option.6

We first compared respondent characteristics by gender. Next, we examined ED patient experience by gender using multivariate linear regression models predicting patient experience scores from gender; models were adjusted for mode of survey administration and respondent characteristics known to be associated with patients’ survey responses (see Table 2).6 Lastly, we added interactions to investigate whether gender differences in patient experience varied by age or the urgency of the condition (captured by patient-reported reason for ED visit and patient-reported importance of getting timely care).


Compared to men, women were younger, less likely to have arrived by ambulance, less often in excellent mental health, and more often had a usual source of care (Table 1). Women reported significantly worse experiences than men for five measures (Table 2): getting timely care (67.0% of women selected the “top-box” (most positive) response vs. 71.4% of men, p<0.001); whether doctors and nurses provided sufficient information about test results (68.2% women vs. 72.6% men, p<0.05); whether someone asked at discharge if they would be able to get follow-up care if needed (77.3% women vs. 81.4% men, p<0.05); and whether they got care within 30 minutes of getting to the emergency room (77.9% women vs. 81.0% men, p<0.05). Men did not report significantly worse experiences than women on any measures. These differences did not vary by urgency of condition or age.

Table 1 Respondent Characteristics By Gender
Table 2 Emergency Department Patient Experience of Care Top-Box Scores by Gender


To our knowledge, this is the first study to examine gender differences in ED experiences among patients with diverse medical conditions. These medium-to-large gender differences are larger and less positive for women compared with gender differences observed in inpatient settings 2 and gender differences identified for measures of “getting needed care” among Medicare beneficiaries.3

ED encounters are brief and sometimes chaotic, with health care providers the patient may have not met before and may not see again. Thus, interpersonal dynamics during ED encounters are fundamentally different than in other care settings, making it critical to be mindful of systematic differences in providers’ communications and decision-making. Training to increase awareness of implicit biases and differences in communication styles can support providers’ ability to communicate effectively with both men and women in ED settings.

Although men and women do not differ in their overall ratings of ED care, there are important and meaningful gender differences in reported experiences, particularly with respect to communication between patients and providers and ED staff responsiveness that should be addressed. Increased focus on women’s experience of care in the ED has the potential to improve ED care for all patients. Gender disparities in health care damage patient-physician relationships, and ultimately patient outcomes. Increased health equity is essential to high-value patient-centered care.


  1. Kane BG, Guillaume AWD, Evans EM, et al. Gender Differences in CDC Guideline Compliance for STIs in Emergency Departments. West J Emerg Med 2017;18(3):390-397.

    Article  Google Scholar 

  2. Elliott MN, Lehrman WG, Beckett MK, Goldstein E, Hambarsoomian K, Giordano LA. Gender differences in patients' perceptions of inpatient care. Health Serv Res 2012;47(4):1482-1501.

    Article  Google Scholar 

  3. Burkhart Q, Elliott MN, Haviland AM, et al. Gender Differences in Patient Experience Across Medicare Advantage Plans. Womens Health Issues 2020.

  4. Anhang Price R, Elliott MN, Zaslavsky AM, et al. Examining the role of patient experience surveys in measuring health care quality. Med Care Res Rev 2014;71(5):522-554.

    Article  Google Scholar 

  5. Centers for Medicare and Medicaid Services. Emergency Department CAHPS (ED CAHPS). Published 2020. Accessed August 1, 2020, 2020.

  6. Parast L, Mathews M, Tolpadi A, Elliott M, Flow-Delwiche E, Becker K. National Testing of the Emergency Department Patient Experience of Care Discharged to Community Survey and Implications for Adjustment in Scoring. Med Care 2019;57(1):42-48.

    Article  Google Scholar 

Download references


This work was supported by the Centers for Medicare & Medicaid Services, Department of Health and Human Services [Contract Number: GS-10F-0275P/75FCMC18F0061].

Author information

Authors and Affiliations


Corresponding author

Correspondence to Peggy G. Chen MD, MSc, MHS.

Ethics declarations


The content of this publication neither necessarily reflects the views or policies of the Department of Health and Human Services nor does the mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. The authors assume full responsibility for the accuracy and completeness of the ideas presented.

Conflict of Interest

The authors have no financial conflicts of interest to disclose.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Prior Presentations: None.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Chen, P.G., Tolpadi, A., Elliott, M.N. et al. Gender Differences in Patients’ Experience of Care in the Emergency Department. J GEN INTERN MED 37, 676–679 (2022).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: