The production of dialysis by for-profit versus not-for-profit freestanding renal dialysis facilities.
OBJECTIVE
A study was conducted to determine whether for-profit and not-for-profit freestanding renal dialysis facilities differ with respect to efficiency in the production of dialysis treatments.


METHODS
National data on 1,224 Medicare-certified freestanding dialysis facilities were obtained from the Health Care Financing Administration's (HCFA) 1990 Independent Renal Dialysis Facility Cost Report. Data on Medicare patients receiving care at these facilities during 1990 were obtained from HCFA's End Stage Renal Disease (ESRD) Program Management and Medical Information System (PMMIS).


METHODS
Ordinary least squares regression (OLS) was used to estimate the association between monthly output of dialysis treatments in 1990 and (a) facility capital and labor inputs, (b) facility ownership characteristics, and (c) case-mix characteristics.


METHODS
Facility and patient level data were extracted from the Facility Cost Report and the PMMIS databases, respectively. Patient level data were aggregated by facility and merged with facility level data.


RESULTS
For-profit sole proprietorships, for-profit partnerships and for-profit corporations each produced significantly more dialysis treatments per month than not-for-profits, adjusting for quantities of resource inputs and case-mix characteristics.


CONCLUSIONS
For-profit facilities appear to be more efficient producers of dialysis treatments than not-for-profits. Further study should address whether other factors such as differences in severity of disease or in quality of care are responsible for these observations.
Griffiths
R I
RI
Division of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205.
Powe
N R
NR
Gaskin
D J
DJ
Anderson
G F
GF
de Lissovoy
G V
GV
Whelton
P K
PK
D000554:Ambulatory Care Facilities / Q000458:organization & administration* / Q000706:statistics & numerical data; D002201:Capital Expenditures; D014487:Centers for Medicare and Medicaid Services, U.S.; D003953:Diagnosis-Related Groups / Q000191:economics; D017598:Efficiency, Organizational; D005260:Female; D006269:Health Facilities, Proprietary; D006302:Health Services Research; D006801:Humans; D016018:Least-Squares Analysis; D008297:Male; D006278:Medicare; D008875:Middle Aged; D010067:Ownership; D006435:Renal Dialysis / Q000191:economics* / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D014481:United States; D016526:Workload / Q000191:economics