Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Devereaux and colleagues1 hypothesized that understaffing and shorter dialysis
treatment time in for-profit dialysis centers were among possible causes for
their higher mortality rates. We think other interpretations are likely. First,
5 of 7 studies in their meta-analysis were published more than 10 years ago
and the data analyzed in these studies were even older. It is possible that
current practice patterns are significantly different. Second, although multivariate
adjustment was carried out for such potential confounding factors as age,
race, and underlying kidney disease, the authors did not assess the quality
of care delivered by nephrologists.
Kalantar-Zadeh K, Mehrotra R, Kopple JD. Quality of Care in Profit vs Not-For-Profit Dialysis CentersQuality of Care in Profit vs Not-For-Profit Dialysis Centers. JAMA. 2003;289(23):3087-3088. doi:10.1001/jama.289.23.3087