OBJECTIVES: There are many differences in health attending to sex and gender, such as pathophysiology, disease’s signs and symptoms, modifiable factors, diagnoses, access to healthcare, or interventions. We analyzed differences by sex in main diagnosis at hospital discharge as an approach to identify potential inequities in healthcare.

METHODS: General groups of hospital discharge diagnoses (CCS, n=258) between 2016 and 2020 for individuals ≥15years old were obtained by sex from the Spanish Ministry of Health’s public database using ICD-10 codification (RAE-CMBD). Rates per 100,000 inhabitants were adjusted by age and year according with the Spanish National Statistics Institute. Rate ratios (RR) and 95%CIs were calculated to ensure a significant difference by sex. Obtained ratios were compared with prevalence rate ratios found in the literature to identify potential disproportionalities in hospital admissions that could be indicative of disparities in management.

RESULTS: We found that 61% of the rates in women were lower, 32% were higher, and 6% were equal. Conditions such as Foot deformities, Thyroid disorders, or Osteoporosis had an RR 4.61(95%CI 4.60-4.62), 3.56(95%CI 3.54-3.57), and 4.02(95%CI 3.97-4.06), higher in women, respectively. Contrarily, Gout and other crystal arthropathies, Urinary bladder cancer, or Cancer of the esophagus, had an RR 6.16(95%CI 6.13-6.19), 6.16(95%CI 6.14-6.17), and 5.73(95%CI 5.70-5.77) higher in men, respectively. When contrasted with published prevalence data by sex, in some conditions highly skewed towards one sex (>75% prevalence of women or men) we found lower RR, indicative of a higher hospitalization rate of the minority sex.

CONCLUSIONS: In this analysis we concentrated in the study of hospital discharge diagnoses by sex using a Spanish dataset, as an approach to identify potential inequities in healthcare. For some conditions highly skewed towards one sex we found higher hospitalization rates of the minority sex which could be indicative of potential suboptimal sex specific detection or management.