Ownership of Dialysis Facilities and Patients' Survival

To the Editor: Garg et al. (Nov. 25 issue) 1 reported on the effect of the ownership of dialysis facilities on patients' survival and referral for transplantation. They described large differences in outcomes among patients undergoing dialysis who had been grouped according to the type of dialysis facility in a sample of facilities. Although they are not cited by the authors, the U.S. Renal Data System (USRDS) has three times published standardized mortality ratios for all facilities, which were grouped according to the three types considered by the authors: free-standing for-profit, free-standing not-for-profit, and hospital facilities. 2 , 3 The standardized mortality ratio, . . .