Mortality rate higher at for-profit hospitals

Patients in for-profit hospitals are more likely to die than those in non-profit hospitals according to a new systematic review and analysis carried out by researchers at McMaster University in Hamilton, Ontario, Canada and the University of Buffalo, New York, USA. They compared mortality in private, for-profit and private, non-profit hospitals in the United States between 1982 and 1995. 15 observational studies that included 26000 hospitals and 38 million patients were reviewed. Some hospitals featured in more than one study. Patients treated at for-profit hospitals had a 2% increased risk of death. In the United States, a 2% increased risk means that 14,000 people die each year at for-profit hospitals who would have lived if treated at non-profit hospitals. In Canada that would mean 2,200 extra deaths per year; about the same number as die from suicide or colon cancer or in traffic crashes. The study fuels debate whether private, for-profit hospitals should be allowed to enter the marketplace. The higher death rate at for-profit hospitals occurs for two reasons: Shareholders expect a 10% to 15% return and the hospitals have to pay taxes. Funding is fixed (from various schemes and from national health insurance) so they cut corners on skills. This study should serve useful for the ongoing international debate about the governance and management of health care systems. These findings should also help re-embrace the core concept of a universal health care system in which the vast majority of services are provided by non-profit institutions with public accountability.