Just a week-and-a-half before the release of the Romanow report on the state of Canadian health care, a new study on dialysis clinics in the United States suggests there is a big difference in the death rate, depending on whether patients are treated at public or for-profit clinics.

Dr. P.J. Devereaux of McMaster University and his colleagues reviewed death rates of more than 500,000 patients getting dialysis in the U.S.

Approximately 20 per cent of dialysis patients in the U.S. are treated at not-for-profit centres, and 80 per cent get dialysis at for-profit run clinics.

Researchers found that those treated in for-profit dialysis clinics had an eight per cent higher risk of dying, and the study estimates it accounts for 2,500 additional deaths in the U.S. each year. About 208,000 people have dialysis every year in the U.S.

CTV News: Researchers find higher death rates at U.S. for-profit kidney dialysis clinics

Canada AM: Dr. P.J. Devereaux, lead author for-profit health care study

"I want to see the best health care system for all Canadians and we want it to be driven by evidence ... and the evidence is there is a higher risk of dying in private-for-profit facilities," Devereaux said. "And we don't see it as being a good option for Canadians."

In Canada, about 13,000 patients receive dialysis each year. Of those, about 2,000 die people die. If Canada were to adopt a for-profit system, researchers predict about 150 more deaths each year.

The study, published in the Nov. 20 edition of the Journal of the American Medical Association, says for-profit dialysis centres "may employ fewer personnel per dialysis run and less-highly skilled personnel."

Researchers also say patients at private clinics may get shorter periods of treatment, which they report is associated with higher mortality rates.

"These for-profit centres have to deliver a profit, and they may choose to cut corners to save money," Devereaux said.

In an article published last spring in the Canadian Medical Association, the same team of researchers argued that introducing for-profit hospitals into this country would result in as many as 2,200 additional deaths each year.

The dialysis clinic study focused on data between January 1973 and December 1997, and included an average of 1,342 facilities per study.

Dr. Brian Murray, of the for-profit Cleve Hill Dialysis Centre in Buffalo, said the study is "retrospective," meaning that it focuses on data complied before improvements to dialysis.

"Practices in dialysis have changed dramatically since then, especially in how for-profit dialysis is provided," Murray said.

The number of for-profit clinics in Buffalo has nearly tripled in the last 10 years. "This means there is no longer a waiting list in Buffalo for hemodialysis, and patients have a choice of type of unit and location," Murray said.

There are only limited facilities in Canada. This could provide an argument for private clinics, but front-line doctors are hesitant.

"I think the not-for-profit system we have now works well, and I would not like to see it changed," said Dr. Euan Carlisle, the director of hemodialysis at St. Joseph's Health care in Hamilton, Ont.

Roy Romanow, the head of the Commission on the Future of Health Care in Canada, is expected to release his report within the next week or so. It will make recommendations on how to sustain the publicly-funded system in Canada.

With a report from CTV's Avis Favaro