What question did this study set out to answer?

The aim is to investigate the gender gap in patient hospitalization within public-private partnership hospitals and identify underlying reasons.

February 28, 2026Open Access

Assessment of gender gap within patients in public-private partnership-based hospital management system: a systematic review and meta-analysis

Key Points

The aim is to investigate the gender gap in patient hospitalization within public-private partnership hospitals and identify underlying reasons.
Conducted a systematic review and meta-analysis following PRISMA guidelines
Searched 389 articles from ScienceDirect, Google Scholar, and PubMed
Included 12 eligible articles and assessed their characteristics and quality
Used funnel and forest plots to analyze odds ratios and study asymmetry
Male patients are more prevalent than female patients with an overall odds ratio of 2.38
Subgroup analysis indicated higher female ratios in hospital readmission and COVID-19 cases
In certain conditions like tuberculosis and cardiovascular diseases, the male ratio is significantly higher
Female patients were primarily prevalent in North America only
Overall, the analysis suggests a need for a more female-friendly environment in PPP hospitals.

Abstract

Public-private partnership (PPP) is now a well-recognized model for different businesses as well as in hospital management systems globally. However, differences in the male-female ratio or gender-gap within patients are still observed among hospitals, primarily indicating that the frequency of female patients is less compared to males. We need to know whether females hardly require treatments through hospitalization, or if they are not comfortable visiting hospitals. Therefore, we tried to investigate the exact gender-gap ratio, reasons, and solutions regarding this vital issue in PPP-based hospitals by analyzing previous research. Following PRISMA guidelines, we sorted 12 eligible articles from 389 articles searched from ScienceDirect, Google Scholar, and PubMed. The characteristics and quality of the included studies were assessed. The funnel plot determined the study asymmetry and outliers, whereas the forest plot assessed the odds ratio (OR) and heterogeneity. We determined overall, male patients were higher in ratio as compared to female patients, with an OR of 2.38 (95% CI: 1.44–3.92). However, subgroup analysis regarding hospital readmission (OR: 0.44) and COVID-19 cases (OR: 0.96) showed a slightly higher female ratio in male-female comparison. In the case of tuberculosis, renal and kidney, Psychiatry, and cardiovascular diseases, the male ratio was higher. In continent-based analysis, female patients were prevalent only in the North American region (OR: 0.65). According to our pooled analysis, we observed a higher prevalence of male patients in PPP-based hospitals. However, in a couple of cases, female patients were found to be prevalent. Among the five continents, male patients were more prevalent than female patients in all, except North America. This analysis indicates that the PPP-based hospital management system needs to ensure a socio-economically balanced, female-friendly environment where female patients would feel more comfortable and safer, with improved infrastructure in rural areas, ensuring equity regarding healthcare facilities.

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