Posted on November 20, 2002

Patients more likely to die in private for-profit dialysis centers, major study finds



Janet Maher (coordinator) cell: 416-770-1311
Dr. P.J. Devereaux pager number 905 521 5030 pager 2530
Dr. P.J. Devereaux office: 905-525-9140 ext. 22160
McMASTER UNIVERSITY, Faculty of Health Sciences, Clinical Epidemiology & Biostatistics

TORONTO, November 19, 2002 _ If Canada switched to for-profit dialysis centers, approximately 150 additional dialysis patients would die each year, according to a major study to be published in the Journal of the American Medical Association (JAMA) tomorrow.

The research builds on finding released by the same research group earlier this year that revealed statistically significant higher death rates in private for-profit hospitals.

“In both hospital and outpatient settings the profit motive drives up death rates,” said Dr. P.J. Devereaux, lead author of the study.

The systematic review and meta-analysis compared death rates in over 500,000 adult patients receiving care in either for-profit or not-for-profit American dialysis facilities. The study found an 8% greater risk of dying in a for-profit facility. The results were extremely consistent across all the studies surveyed. They showed that if American patients received care in private not-for-profit dialysis facilities instead of for-profit facilities, approximately 2,500 lives would be saved each year.

“The reason more patients are dying in for-profit facilities is that administrators must spend 10 to 15 per cent of all expenses satisfying shareholders and paying taxes.” said Dr. Devereaux. “For-profit providers cut corners to ensure shareholders achieve their expected returns on investment.”

The results of this review are directly relevant to over 12,000 Canadians receiving dialysis. First, the studies included patients receiving publicly financed care in private not-for-profit and private for-profit dialysis facilities, a situation identical to what Canadian policy-makers have been considering. Second, the results are consistent over time, despite changes in American health care. Third, if Canada moved to for-profit dialysis facilities, the same large American dialysis chains included in the review would be purchasing Canadian dialysis facilities.

The results come at a time when Senator Kirby is advocating a permissive stance with regards to private for-profit health care facilities and a number of provinces have allowed for-profit MRI facilities and surgical facilities. The study results suggest that the profit motive may be compromising care in all out-patient for-profit clinics and hospital.

“Our results should raise serious concerns about moves to private for-profit care, whether in hospitals, day surgeries, or other outpatient facilities. It is time to base health care policy on evidence, not ideology.”

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Physicians for a National Health Program has been advocating for a single-payer national health program since 1987, with more than 12,000 members across the United States.
PNHP is headquartered in Chicago.