Do Not-For-Profit Nursing Homes Provide Better Quality Care?



Do Not-For-Profit Nursing Homes Provide Better Quality Care?
05 Aug 2009

On average, not-for-profit nursing homes deliver higher quality care
than do for-profit nursing homes, according to a study published on
bmj.com today.

However, the authors stress that many factors may influence this
relation and more work is needed to explore the impact of profit
status on the quality of care delivered.

Concerns about quality of care in nursing home care are widespread. In
the United States two thirds of nursing homes are for-profit
institutions, while in Canada, just over half of nursing homes are in
for-profit ownership. Similarly, in the UK, more than half of
healthcare beds belong to independent nursing homes for older people,
most of which are operated by for-profit institutions.

So a team of researchers based in Canada analysed the results of 82
studies spanning 1965 to 2003 comparing quality of care in for-profit
and not-for-profit nursing homes. Most of the studies were carried out
in the US and Canada.

Differences in study design and quality were taken into account to
minimise bias.

Forty studies showed significantly better quality in not-for-profit
homes, while three studies favoured quality of care in for-profit
homes. The remaining studies had mixed results suggesting that,
although the average effect is clear, there is substantial variation
across institutions.

Further analysis suggested that not-for-profit facilities delivered
higher quality care than did for-profit facilities for two of the four
most frequently used quality measures: more or higher quality staffing
and lower pressure ulcer prevalence.

The analysis also favoured not-for-profit homes in the other two
measures: use of physical restraint and lower regulatory agency
deficiencies. But these results were not statistically significant.

Based on these findings, the authors estimate that nursing home
residents in Canada would receive roughly 42,000 more hours of nursing
care per day and those in the United States would receive 500,000 more
hours of nursing care per day if not-for-profit institutions provided
all nursing home care.

Similarly, they estimate that 600 of 7,000 residents with pressure
ulcers in Canada, and 7,000 of 80,000 residents with pressure ulcers
in the United States are attributable to for-profit ownership.

These findings provide insight into average effects and suggest a
trend towards higher quality care in not-for-profit facilities than
for-profit homes, write the authors. However, more work is now
required to explore the factors that influence this relationship, they
conclude.

This view is supported by Professor Tamara Konetzka from the
University of Chicago in an accompanying editorial, who believes that
more data are needed to increase our understanding of the association
between profit status and the quality of nursing homes.

But she points out that many factors other than profit status have
been strongly linked to the quality of nursing home care, and warns
that, "if differences in quality between for-profit and not-for-profit
nursing homes stem at least in part from differences in revenues
rather than mission, eliminating for-profit homes may do little to
eliminate differences in quality."

Link to Article

Link to Editorial

Source
British Medical Journal
--------------------------------------------------------------------------------

Article URL: http://www.medicalnewstoday.com/articles/159885.php

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