By Brian Carnell

Thursday, June 20, 2002

The BBC recently published an unintentionally hilarious article on a study published in the Canadian Medical Association Journal. The headlined blared, 'More die in private hospitals' - researchers.

After supposedly studying the medical records of nearly 40 million people over a 13-year period, the researchers concluded that more people die in private hospitals than in public ones. The BBC continued,

The researchers have suggested the higher mortality rate may be because hospitals run for profit in the US have to pay dividends so shareholders and tax, and have less money to spend on patients.

They say their findings should discourage Canada from privatising its healthcare system.

In fact this was a meta-analysis of 15 different studies and the best it could do was find a whopping two percent difference in adjusted mortality rates. That low of a difference is statistically irrelevant. A better way to summarize the findings would have been, "Study find no difference in mortality rates between profit and non-profit hospitals."

In fact, Canadian Medical Association Journal implicitly recognized this by wondering if the true effect wasn't hidden by the methodology of the study,

Although studies that analyzed hospitals that changed ownership status were excluded from the meta-analysis, the admissions to hospital that were studied took place at a time when hospitals were characterized by a variety of forms of ownership. Some were long-term not-for-profit hospitals, some long-term for-profit hospitals, some were about to convert, some had just converted, and so on. This information is not characterized or controlled for in the studies included in the meta-analysis. The dilution of the "true effect" of ownership type is likely to bias findings of relative mortality comparing not-for-profit and for-profit hospitals toward no difference. Thus, the mortality difference found is likely to be a conservative estimate.

That is the smell of desperation.

Source:

'More die in private hospitals' - researchers. The BBC, May 28, 2002.

A systematic review and meta-analysis of studies comparing mortality rates of private for-profit and private not-for-profit hospitals. P.J. Devereaux, et al. Canadian Medical Association Journal, May 28, 2002; 166(11).

What price for-profit hospitals? Donald H. Taylor, Jr, Canadian Medical Assocation Journal, May 28, 2002; 166(11).

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