Profit vs. non-profit health care

May 27, 2002

P.J. Devereaux* and colleagues provide new fodder for the current discussions about private, for-profit health care delivery in Canada with a systematic review and meta-analysis of studies comparing mortality rates in private for-profit and private not-for-profit hospitals in the United States.

The authors reviewed and analyzed 15 observational studies involving more than 26 000 hospitals and 38 million patients. They found that in the 15 studies of adult populations, with adjustments for potential confounders, private for-profit hospitals were associated with an increased risk of death. In the one perinatal study that met the eligibility criteria, they found that there was an increased risk of death in private for-profit hospitals.

In related Commentaries on the relevance of these findings for Canadians, David Naylor and Donald Taylor argue that this new evidence should give proponents of for-profit care reason to pause and provide new ammunition for advocates of not-for-profit care.

"In my view, these findings should also help Canadians re-embrace the core concept of a universal health care system in which the vast majority of services are provided by nonprofit institutions with public accountability," concludes Naylor.

Canadian Medical Association Journal

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