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June 18, 2003

Quality of Care in Profit vs Not-For-Profit Dialysis CentersQuality of Care in Profit vs Not-For-Profit Dialysis Centers

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(23):3087-3088. doi:10.1001/jama.289.23.3087

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.

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