SynthesisCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2002
A systematic review and meta-analysis of studies comparing mortality rates of private for-profit and private not-for-profit hospitals.
Synthesis in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
60 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Pharmaceutical policies: effects of regulating drug insurance schemes.The Cochrane database of systematic reviews · 2022Pooled it
- Governance arrangements for health systems in low-income countries: an overview of systematic reviews.The Cochrane database of systematic reviews · 2017Pooled it
- Quality of care in for-profit and not-for-profit nursing homes: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2009Pooled it
- Payments for care at private for-profit and private not-for-profit hospitals: a systematic review and meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2004Pooled it
- Article
- The role of context in strategic human resource management within private hospitals in Ethiopia, compared to public hospitals.Frontiers in health services · 2026Article
- Predicting High Urinary Tract Infection Rates in Skilled Nursing Facilities: A Machine Learning Approach.Healthcare (Basel, Switzerland) · 2025Article
- Association of hospital for-profit status with clinical and financial outcomes following emergency general surgery.Surgery open science · 2025Article
- Hospital Ownership Type Correlated With Investments in Nursing Services: Evidence From Illinois.Medical care · 2025Article
- The Fraying at the Edges of the Public Healthcare System in Canada.Healthcare policy = Politiques de sante · 2025Article
- Behind the Hospital Ward: In-Hospital Mortality of Type 2 Diabetes Mellitus Patients in Indonesia (Analysis of National Health Insurance Claim Sample Data).International journal of environmental research and public health · 2024Article
- The best defence is a good offence: Ensuring equitable access to primary care in Canada.Healthcare management forum · 2023Article
- Century-Long Trends in the Financing and Ownership of American Health Care.The Milbank quarterly · 2023Article
- The relationship between hospital ownership, in-hospital mortality, and medical expenses: an analysis of three common conditions in China.Archives of public health = Archives belges de sante publique · 2023Article
- For-profit hospitals have a unique opportunity to serve as anchor institutions in the U.S.Preventive medicine reports · 2021Article
- For-Profit Hospitals Have Thrived Because of Generous Public Reimbursement Schemes, Not Greater Efficiency: A Multi-Country Case Study.International journal of health services : planning, administration, evaluation · 2021Article
- Measuring Quality in Home Healthcare.Journal of the American Geriatrics Society · 2019Article
- GRADE guidelines: 18. How ROBINS-I and other tools to assess risk of bias in nonrandomized studies should be used to rate the certainty of a body of evidence.Journal of clinical epidemiology · 2019Article
- The Growing Executive-Physician Wage Gap in Major US Nonprofit Hospitals and Burden of Nonclinical Workers on the US Healthcare System.Clinical orthopaedics and related research · 2018Article
- Editor's Spotlight/Take 5: The Growing Executive-Physician Wage Gap and Burden of Nonclinical Workers on the U.S. Healthcare System.Clinical orthopaedics and related research · 2018Article
Corrections and comments
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCanadians are engaged in an intense debate about the relative merits of private for-profit versus private not-for-profit health care delivery. To inform this debate, we undertook a systematic review and meta-analysis of studies comparing the mortality rates of private for-profit hospitals and those of private not-for-profit hospitals.
methodsWe identified studies through an electronic search of 11 bibliographical databases, our own files, consultation with experts, reference lists, PubMed and SciSearch. We masked the study results before determining study eligibility. Our eligibility criteria included observational studies or randomized controlled trials that compared private for-profit and private not-for-profit hospitals. We excluded studies that evaluated mortality rates in hospitals with a particular profit status that subsequently converted to the other profit status. For each study, we calculated a relative risk of mortality for private for-profit hospitals relative to private not-for-profit hospitals and pooled the studies of adult populations that included adjustment for potential confounders (e.g., teaching status, severity of illness) using a random effects model.
resultsFifteen observational studies, involving more than 26 000 hospitals and 38 million patients, fulfilled the eligibility criteria. In the studies of adult populations, with adjustment for potential confounders, private for-profit hospitals were associated with an increased risk of death (relative risk [RR] 1.020, 95% confidence interval [CI] 1.003-1.038; p = 0.02). The one perinatal study with adjustment for potential confounders also showed an increased risk of death in private for-profit hospitals (RR 1.095, 95% CI 1.050-1.141; p < 0.0001).
interpretationOur meta-analysis suggests that private for-profit ownership of hospitals, in comparison with private not-for-profit ownership, results in a higher risk of death for patients.
Indexed as
Identifiers
12054406PMC111211What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.