May. 27, 06:55 EDT
  Study links for-profit care, high death rates
  Hospital death rates could rise by up to 2,200 a year, researchers claim
  From Canadian Press

  Death rates would rise if Canada allowed for-profit hospitals, study says
Introducing private, for-profit hospitals
  into the Canadian health-care system would increase hospital deaths by as many
as 2,200 a year, a new study
  suggests.

  A consortium of researchers from Canada and the United States jointly analysed
15 American studies comparing
  death rates in for-profit hospitals to those of not-for-profit institutions.
The studies, which included data on 38
  million patients in 26,000 hospitals over a time span of 15 years, showed the
death rate in for-profit hospitals was
  two per cent higher than that of not-for-profit institutions.

  The researchers applied that two-per-cent figure to the number of Canadians
who die in hospital each year -
  currently about 108,000 - to come up with the estimate of the impact
for-profit hospitals would have on hospital
  mortality rates in this country.

  The results, published Tuesday in the Canadian Medical Association Journal,
should send a sobering message
  to  those keen on inviting the private sector to play a greater role in
Canada's ailing health-care system, the
  authors say.

  "(Alberta Premier) Ralph Klein has indicated at the last premiers conference
that he did not think that the public
  cared who delivered their care, as long as it remained government funded,"
said lead author Dr. Philip
  Devereaux.

  "Our research suggests that in fact the public should care."

  The impact of a two-per-cent increase in deaths - which the authors believe is
a conservative estimate - is
  roughly equivalent to the number of Canadians who die in motor vehicle
accidents or commit suicide each year,
  noted Devereaux, a cardiologist at McMaster University in Hamilton.

  "I think that within this debate people have been hearing for so long that
privatization is the answer, i.e. private
  for-profit, that people have started to accept it," he said at a news
conference.

  "And that's why I think it's important to hear the results and to step back
and think about that. And say: `Why
  would we consider switching to this?'"

  While the findings will undoubtedly play a role in the ongoing debate over the
future of health care in this country,
  not everyone was willing to acknowledge that what has played out in the United
States would play out in
  Canada.

  Dr. Wilbert Keon, a prominent Ottawa heart surgeon and a member of the Senate,
agreed a two-per-cent higher
  mortality rate in for-profit hospitals would be unacceptable in the Canadian
context.

  But Keon, who recently said it was time for Canadians to embrace private
health care, said that if hospitals in this
  country were privatized they would have to meet strict quality standards set
by a federal agency. And he insisted
  it is too soon to eliminate options in the search to find new ways to inject
cash into the struggling health-care
  system.

  "I think this study is well done, by very good people. But I do think we have
to keep an open mind. And I think
  we do have to look at ways of delivering quality care at a reduced cost," Keon
said.

  Still, the findings convinced the dean of medicine at the University of
Toronto, who was not involved in the study.

  "Does anyone still want to contract out large segments of our publicly
financed health-care system to for-profit
  U.S. hospital chains after reading this article? I hope not," Dr. David Naylor
wrote in a commentary on the article
  also featured in this week's journal.

  The team of 17 researchers, who are mainly from McMaster and the universities
of Toronto and Buffalo, N.Y.,
  set out to find out if there were any health consequences of delivering
hospital care in a for-profit setting.

  So they did what's known as a meta-analysis, searching for all studies
comparing death rates in for-profit versus
  not-for-profit hospitals in the United States. The idea behind a meta-analysis
is to connect the dots, to group all
  relevant research on a topic together so that scientists can see the big
picture rather than focus on one individual
  finding.

  Because the issue is so politically charged, they decided to initially "mask"
the studies - blocking out the outcome
  so that researchers could not be tempted to include or exclude studies based
on what they found rather than what
  they looked at and how they were conducted.

  Fifteen studies met the criteria and were included in the meta-analysis. All
but one study showed higher death
  rates in for-profit hospitals.

  The reason seemed clear, Devereaux said: Hospitals that had to both generate
profits for shareholders and pay
  taxes - not-for-profit hospitals didn't pay taxes - spent less money on
nurses, doctors, pharmacists and other
  health-care professionals.

  "To maintain the profits . . . corners are being cut on the delivery of health
care, which is directly important to
  actual health outcomes."

  The authors believe the results are applicable to Canada, pointing out that
the U.S. multinationals who own the
  for-profit hospitals in the American system would likely be the buyers if
Canadian hospitals were put on the
  block.

  The study, which cost roughly $55,000 to conduct, was funded through an
Atkinson Foundation research grant
  and a Hamilton Health Sciences research development grant.

Send one line: unsubscribe click4hp to: [log in to unmask] to unsubscribe
See: http://listserv.yorku.ca/archives/click4hp.html to alter your subscription