Dialysis patients may benefit more from nonprofit centers

November 24, 1999
Web posted at: 6:33 p.m. EST (2333 GMT)

(CNN) -- Dialysis patients have a better chance of receiving a kidney transplant and a higher survival rate when treated at not-for-profit dialysis centers than at for-profit centers, according to research in this week's New England Journal of Medicine.

"The findings "raise serious concern about the quality of care that's provided in community-based for-profit facilities," said Dr. Pushkal Garg, Harvard Medical School.

Researchers compared the quality of care in for-profit and not-for-profit free-standing dialysis centers and found patients were 20 percent more likely to die, and 26 percent less likely to be placed on a waiting list for a kidney transplant, in for-profit facilities than in not-for-profit.

More than 230,000 American receive dialysis treatment for advanced kidney disease. The number of people with this condition is increasing by about 10 percent a year.

The U.S. government, through Medicare, pays 80 percent of all dialysis costs.

"Dialysis providers are paid a fixed amount for providing dialysis treatment, and that amount has not increased since 1973," Garg said.

Kidney specialist Dr. Norman Levinsky of Boston University Medical Center said a shrinking bottom line has forced profit centers to cut corners.

"(There is) a tendency to reduce the number of staff for a group of patients, to shift from nurses who are trained to take care of patients to technicians who are less expensive," he said.

These financial pressures mean there may not be adequate staff to discuss the option of kidney transplantation, which is a better treatment and increases chances for survival.

For those who are receiving dialysis treatment at a for-profit center, researchers say that based on this one study, there is no reason to panic or switch to a non-profit center.