August, 19 2009, 10:41am EDT
For Immediate Release
Contact:
Gordon Guyatt, M.D., (905) 525-9140
P.J. Devereaux, M.D., (905) 525-9140
Mark Almberg, Physicians for a National Health Program,
(312) 782-6006, cell: (312) 622-0996, mark@pnhp.org
Nonprofit Nursing Homes Provide Better Care, Major Study Finds
For-profit homes faulted for lower staffing, higher rate of bedsores
WASHINGTON
A
major new statistical review of 82 individual research studies has
revealed that nonprofit nursing homes deliver, on average, higher
quality care than for-profit nursing homes. The findings could have a
bearing on the present debate about the role of for-profit firms in
U.S. health reform.
"The
results are unequivocal and completely consistent with other studies
comparing for-profit versus nonprofit care," said Dr. Gordon Guyatt,
senior author of the study, professor of medicine at McMaster
University in Hamilton, Canada, and a world leader in "evidence-based
medicine," a term he coined. The study was published in the online
edition of the British Medical Journal earlier this month.
The
authors' systematic review compared quality-of-care measurements in 82
individual studies that collected data from 1965 to 2003 involving tens
of thousands of nursing homes, mostly in the United States.
In
40 of the 82 studies, all statistically significant comparisons favored
nonprofit facilities. In three studies, all significant comparisons
favored for-profit facilities. The remaining studies had less
consistent findings.
The
authors' meta-analysis, i.e. their integration and statistical analysis
of the data from the multiple studies, shows that nonprofit facilities
delivered higher quality care than for-profit facilities for two of the
four most frequently reported quality measures: (1) more or higher
quality staffing and (2) less prevalence of pressure ulcers, sometimes
called bedsores.
The
results also suggest better performance of nonprofit homes in two other
quality measures: less frequent use of physical restraints and fewer
noted deficiencies (quality violations) in governmental regulatory
assessments.
"The
reason patients' quality of care is inferior in for-profit nursing
homes is that administrators must spend 10 percent to 15 percent of
revenues satisfying shareholders and paying taxes," said Guyatt.
"For-profit providers cut corners to ensure shareholders achieve their
expected return on investment."
About
1.5 million people reside in nearly 16,000 nursing homes in the United
States, and more than 3 million Americans will spend at least some time
in a nursing home this year, according to the U.S. Centers for Medicare
and Medicaid Services. About two-thirds of U.S. nursing home residents
live in for-profit facilities.
The
findings have significant patient-care implications. For example, the
study suggests that of the estimated 80,000 U.S. nursing home residents
who presently have bedsores, 7,000 of these cases are attributable to
for-profit ownership. Similarly, the results suggest U.S. residents
would receive about 500,000 more hours of nursing care per day if
nonprofit institutions replaced for-profit nursing homes.
While
most of the data in the studies are from U.S. nursing homes, data from
Canada and Taiwan were also reviewed. Results were consistent over time.
The
authors note that the results are entirely consistent with other
studies. Systematic reviews of the evidence have previously shown
higher death rates in for-profit versus nonprofit hospitals, and in
for-profit versus nonprofit dialysis facilities. Such reviews have also
shown higher costs in for-profit hospitals. Studies of outpatient care
have shown higher quality of care in not-for-profit settings.
"Our
results should raise serious concerns about for-profit care, whether in
nursing homes, hospitals, surgi-centers, or other outpatient
facilities," Guyatt said. "It is time to base health care policy on
evidence, not ideology."
*******
"Quality
of care in for-profit and not-for-profit nursing homes: systematic
review and meta-analysis," Vikram R Comondore, P J Devereaux, Qi Zhou,
Samuel B Stone, Jason W Busse, Nikila C Ravindran, Karen E Burns, Ted
Haines, Bernadette Stringer, Deborah J Cook, Stephen D Walter, Terrence
Sullivan, Otavio Berwanger, Mohit Bhandari, Sarfaraz Banglawala, John N
Lavis, Brad Petrisor, Holger Schunemann, Katie Walsh, Neera Bhatnagar,
and Gordon H Guyatt. BMJ 2009;339:b2732, doi: 10.1136/bmj.b2732, Aug.
4, 2009.
A copy of the study can be found here: www.pnhp.org/nursing_home
Physicians for a National Health Program is a single issue organization advocating a universal, comprehensive single-payer national health program. PNHP has more than 21,000 members and chapters across the United States.
LATEST NEWS
Biden Commutes 1,500 Sentences and Issues 39 Pardons—But Leaves 40 People on Death Row
"State-sanctioned murder is not justice, and President Biden has an opportunity and an obligation to save lives," Democratic Rep. Ayanna Pressley said earlier this week.
Dec 12, 2024
U.S. President Joe Biden on Thursday announced that he is commuting the sentences of nearly 1,500 Americans and pardoning 39 people convicted of nonviolent crimes, a move the White House described as "the largest single-day grant of clemency in modern history."
But the president's sweeping use of his clemency power as his term nears its conclusion did not appear to extend to any of the 40 men currently on death row—some of whom have been there for decades.
According to a White House fact sheet, those who received commutations "have been serving their sentences at home for at least one year under the Covid-era CARES Act," a law that extended the amount of time in which people could be placed in home confinement to reduce the spread of the virus in prisons.
The White House did not name those who received pardons or commutations but said the list includes a "decorated military veteran," a "nurse who has led emergency response for several natural disasters," and "an addiction counselor who volunteers his time to help young people find their purpose."
The Biden Justice Department paused federal executions in 2021, but President-elect Donald Trump pledged on the campaign trail to expand the use of the death penalty and is expected to allow the executions of the 40 men on death row to take place if they're still there when he takes office next month.
In a statement on Thursday, Biden said that he has "the great privilege of extending mercy to people who have demonstrated remorse and rehabilitation, restoring opportunity for Americans to participate in daily life and contribute to their communities, and taking steps to remove sentencing disparities for non-violent offenders, especially those convicted of drug offenses."
"That is why, today, I am pardoning 39 people who have shown successful rehabilitation and have shown commitment to making their communities stronger and safer," the president said. "I am also commuting the sentences of nearly 1,500 people who are serving long prison sentences—many of whom would receive lower sentences if charged under today’s laws, policies, and practices. These commutation recipients, who were placed on home confinement during the Covid pandemic, have successfully reintegrated into their families and communities and have shown that they deserve a second chance."
Biden, who campaigned on ending the death penalty at the federal level, vowed to "take more steps in the weeks ahead" as his administration reviews clemency petitions, leaving open the possibility of commutations for death row prisoners.
But he's running out of time, human rights organizations, religious leaders, former federal judges, and progressive lawmakers have warned in recent days as they've ramped up pressure on Biden to act.
"State-sanctioned murder is not justice, and President Biden has an opportunity and an obligation to save lives and make good on his campaign promise to address the federal death penalty before leaving office," Rep. Ayanna Pressley (D-Mass.) said at a press conference earlier this week. "With the incoming administration planning to execute the 40 individuals on death row, we're calling on the president to use his clemency authority to commute their death sentences and resentence them to a prison term."
Keep ReadingShow Less
Despite 100% Pentagon Audit Failure Rate, House Passes $883.7 Billion NDAA
"Instead of fighting the rising cost of healthcare, gas, or groceries, this Congress prioritized rewarding the wealthy and well-connected military-industrial complex," said Defense Spending Reduction Caucus co-chairs.
Dec 11, 2024
Despite the Pentagon's repeated failures to pass audits and various alarming policies, 81 Democrats in the U.S. House of Representatives voted with 200 Republicans on Wednesday to advance a $883.7 billion annual defense package.
The Servicemember Quality of Life Improvement and National Defense Authorization Act (NDAA) for Fiscal Year 2025, unveiled by congressional negotiators this past Saturday, still needs approval from the Senate, which is expected to vote next week. U.S. Sen. Bernie Sanders (I-Vt.) said Wednesday that he plans to vote no and spoke out against the military-industrial complex.
The push to pass the NDAA comes as this congressional session winds down and after the U.S. Department of Defense (DOD) announced last month that it had failed yet another audit—which several lawmakers highlighted after the Wednesday vote.
Reps. Mark Pocan (D-Wis.) and Barbara Lee (D-Calif.), co-chairs and co-founders of the Defense Spending Reduction Caucus, said in a joint statement, "Time and time again, Congress seems to be able to find the funds necessary to line the pockets of defense contractors while neglecting the problems everyday Americans face here at home."
"Instead of fighting the rising cost of healthcare, gas, or groceries, this Congress prioritized rewarding the wealthy and well-connected military-industrial complex with even more unaccountable funds," they continued. "After a seventh failed audit in a row, it's disappointing that our amendment to hold the Pentagon accountable by penalizing the DOD's budget by 0.5% for each failed audit was stripped out of the final bill. It's time Congress demanded accountability from the Pentagon."
"While we're glad many of the poison pill riders that were included in the House-passed version were ultimately removed from the final bill, the bill does include a ban on access to medically necessary healthcare for transgender children of service members, which will force service members to choose between serving their country and getting their children the care they need," the pair noted. "The final bill also failed to expand coverage for fertility treatments, including in vitro fertilization (IVF), for service members regardless of whether their infertility is service-connected."
Several of the 124 House Democrats who voted against the NDAA cited those "culture war" policies, in addition to concerns about how the Pentagon spends massive amounts of money that could go toward improving lives across the country.
"Once again, Congress has passed a massive military authorization bill that prioritizes endless military spending over the critical needs of American families. This year's NDAA designates $900 billion for military spending," said Rep. Ilhan Omar (D-Minn.), noting the audit failures. "While I recognize the long-overdue 14.5% raise for our lowest-ranking enlisted personnel is important, this bill remains flawed. The bloated military budget continues to take away crucial funding from programs that could help millions of Americans struggling to make ends meet."
Taking aim at the GOP's push to deny gender-affirming care through TRICARE, the congresswoman said that "I cannot support a bill that continues unnecessary military spending while also attacking the rights and healthcare of transgender youth, and for that reason, I voted NO."
As Omar, a leading critic of the U.S.-backed Israeli assault on the Gaza Strip, also pointed out: "The NDAA includes a provision that blocks the Pentagon from using data on casualties and deaths from the Gaza Ministry of Health or any sources relying on those statistics. This is an alarming erasure of the suffering of the Palestinian people, ignoring the human toll of ongoing violence."
Israel—which receives billions of dollars in annual armed aid from the United States—faces a genocide case at the International Court of Justice and the International Criminal Court last month issued arrest warrants for Israeli Prime Minister Benjamin Netanyahu and former Israeli Defense Minister Yoav Gallant. The NDAA includes over $627 million in provisions for Israel.
Congresswoman Delia Ramirez (D-Ill.), who voted against the NDAA, directed attention to U.S. President-elect Donald Trump's proposed Department of Government Efficiency (DOGE), set to be run by billionaires Elon Musk and Vivek Ramaswamy.
"How do we know that DOGE is not a good-faith effort to address wasted funding and unaccountable government? The NDAA passed today," Ramirez said. "Republicans overwhelmingly supported the $883.7 billion authorization bill even though the Pentagon just failed its seventh audit in a row."
"Billions of dollars go to make defense corporations and their investors, including Members of Congress, rich while Americans go hungry, families are crushed by debt, and bombs we fund kill children in Gaza," she added. "No one who voted for this bill can credibly suggest that they care about government waste."
Rep. Ro Khanna (D-Calif.), who also opposed the NDAA, wrote in a Tuesday opinion piece for MSNBC that he looks forward to working with DOGE "to reduce waste and fraud at the Pentagon, while strongly opposing any cuts to programs likeSocial Security, Medicare, the Department of Veterans Affairs, or the Consumer Financial Protection Bureau."
"We should make defense contracting more competitive, helping small and medium-sized businesses to compete for Defense Department projects," Khanna argued. "The Defense Department also needs better acquisition oversight. Defense contractors have gotten away with overcharging the Pentagon and ripping off taxpayers for too long."
"Another area where we can work with DOGE is reducing the billions being spent to maintain excess military property and facilities domestically and abroad," he suggested. "Finally, DOGE can also cut the Nuclear-Armed Sea-Launched Cruise Missile program."
The congressman, who is expected to run for president in 2028, concluded that "American taxpayers want and deserve the best return on their investment. Let's put politics aside and work with DOGE to reduce wasteful defense spending. And let's invest instead in domestic manufacturing, good-paying jobs, and a modern national security strategy."
Keep ReadingShow Less
After Another US Security Council Veto, UN General Assembly Votes for Gaza Cease-Fire
The General Assembly also voted 159-9 with 11 abstentions in favor of a resolution supporting UNRWA.
Dec 11, 2024
Following yet another United States veto of a United Nations Security Council resolution calling for a cessation of hostilities in Gaza, members of the U.N. General Assembly voted overwhelmingly Wednesday in favor of an "immediate, unconditional, and permanent cease-fire" in the Palestinian enclave, where Israeli forces continued relentless attacks that killed dozens more Palestinians, including numerous children.
The veto by the United States, a permanent Security Council member, came during an emergency special session and was the lone dissenting vote on the 15-member body. It was the fourth time since October 2023 that the Biden administration vetoed a Security Council resolution on a Gaza cease-fire.
"At a time when Hamas is feeling isolated due to the cease-fire in Lebanon, the draft resolution on a cease-fire in Gaza risks sending a dangerous message to Hamas that there's no need to negotiate or release the hostages," Robert Wood, the United States' deputy U.N. ambassador, said ahead of Wednesday's vote.
The 193-member U.N. General Assembly (UNGA) subsequently voted 158-9, with 13 abstentions, for a resolution demanding "an immediate, unconditional, and permanent ceasefire, to be respected by all parties," and calling for the "immediate and unconditional release of all hostages" held by Hamas.
The nine countries that opposed the measure are the United States, Israel, Argentina, Czechia, Hungary, Nauru, Papua New Guinea, Paraguay, and Tonga.
In a separate vote Wednesday, 159 UNGA members voted in favor of a resolution affirming the body's "full support" for the United Nations Relief and Works Agency for Palestine Refugees in the Near East. UNRWA has been the target of diplomatic and financial attacks by Israel and its backers—who have baselessly accused the lifesaving organization of being a terrorist group—and literal attacks by Israeli forces, who have killed more than 250 of the agency's personnel.
Nine UNGA members opposed the measure, while 11 others abstained. Security Council resolutions are legally binding, while General Assembly resolutions are not, and are also not subject to vetoes.
Wednesday's U.N. votes took place amid sustained Israeli attacks on Gaza including a strike on a home sheltering forcibly displaced Palestinians in Deir al-Balah that killed at least 33 people, including children, local medical officials said. This followed earlier Israeli attacks, including the Monday night bombing of the al-Kahlout family home in Beit Hanoun that killed or wounded dozens of Palestinians and reportedly wiped the family from the civil registry.
"We are witnessing a massive loss of life," Dr. Hussam Abu Safiya, director of Kamal Adwan Hospital in Beit Lahia,
toldThe Associated Press.
Since the October 7, 2023 Hamas-led attack on Israel, at least 162,000 Palestinians in Gaza have been killed, maimed, or left missing by Israel's bombardment, invasion, and siege of the coastal enclave, according to officials there. More than 2 million others have been forcibly displaced, starved, or sickened by Israel's onslaught.
Israel's conduct in the war is the subject of a South Africa-led genocide case before the International Court of Justice in The Hague. The International Criminal Court has also issued arrest warrants for Israeli Prime Minister Benjamin Netanyahu and former Israeli Defense Minister Yoav Gallant, as well as one Hamas leader, for alleged war crimes and crimes against humanity.
Keep ReadingShow Less
Most Popular