For-profit kidney care a health hazard

Kidney patients in American private, for-profit dialysis clinics are less likely to be put on transplant waiting lists and more likely to die than patients in public clinics, according to a recent New England Journal of Medicine study.

Researchers found patients in for-profit facilities were 20 per cent more likely to die than those in not-for-profit facilities. The likelihood that a patient would be put on the waiting list for a kidney transplant was 26 per cent lower in for-profit facilities.

The researchers raised the possibility that the for-profit centres are reluctant to refer patients for transplant because it will mean losing dialysis revenue. While the researchers draw no hard conclusions, the mere suggestion is chilling.

The study also concluded that private clinics are understaffed. With declining Medicare funding for dialysis, for-profit clinics are cutting other corners to maintain and boost their profits by reducing staff levels and replacing nurses with lower-paid technicians.

A related Johns Hopkins University study found that for-profit clinics administered more frequent and smaller doses of a kidney treatment drug so as to maximize their Medicare reimbursements — which are a fixed payment per dose — and their profits.