Devereaux, P. J., Schunemann, H. J., Ravindran, N., Bhandari, N., Garg, A. X., Choi, P. T-l., Brydon, J. B., Haines, T., Lachetti, C., Weaver, B., Lavis, J. N., Cook, D. J., Haslam, D. R. S., Sullivan, T., and Guyatt, G. H. ôComparison of mortality between private for-profit and private not-for-profit hemodialysis centers: A systematic review and meta-analysis. Journal of the American Medical Association. 288, 2449-2457. 2002.
This paper is about how the race for profits can be highly detrimental to patientsÆ welfare, and even significantly increase their mortality risk. The majority (95 percent) of hemodialysis in the United States is provided by private for-profit and private not-for-profit centers, and only five percent is provided by public facilities (Devereaux et al, 2449). This study compared mortality rates at private for-profit and private not-for profit centers. It has been proposed that private for-profit dialysis centers can provide treatment more efficiently than not-for profit centers (Relman and Rennie, 996-996), but some critics believe that for-profit facilities may compromise health care standards to maximize profits, since shareholders expect a 10 percent to 15 percent return on their investment (Nudelman and Andrews, 1057-1059; Woolhandler and Himmelstein, 444-446). A debate continues to rage as to whether private for-profit dialysis centers can really provide the same standard of care patients receive at a private not-for profit dialysis center, given their responsibility to earn profits for their shareholders (Garg and Powe, 153-156; Bander, Hakim, Lazarus and Lindenfeld, 13-15; Nissenson and Owen, 232-23).
To determine the comparative mortality rates at the two types of centers, the researchers performed an extremely thorough review of the available literature, which consisted of using 11 bibliographic databases, including EMBASE, MEDLINE, HealthSTAR, CINAHL, BIOETHICSLINE, Wilson Business Ab...