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Public/private ownership and quality of care: Evidence from Danish nursing homes

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  • Hjelmar, Ulf
  • Bhatti, Yosef
  • Petersen, Ole Helby
  • Rostgaard, Tine
  • Vrangbæk, Karsten

Abstract

The involvement of private for-profit (FP) and not-for-profit (NFP) providers in the otherwise public delivery of welfare services is gradually changing the Nordic welfare state towards a more market-oriented mode of service delivery. This article examines the relationship between ownership and quality of care in public and private FP and NFP nursing homes in Denmark. The analysis draws on original survey data and administrative registry data (quality inspection reports) for the full population of almost 1000 nursing homes in Denmark. Quality is measured in terms of structural quality, process quality and outcome quality. We find that public nursing homes have a higher structural quality (in terms of, for instance, staffing), while FP providers perform better in terms of process quality (e.g. in the form of individualised care). NFP providers perform well in terms of structural criteria such as employment of full-time staff and receive fewer critical comments in the inspection reports. However, the results depend to some extent upon the method of data collection, which underlines the benefits of using multiple data sources to examine the relationship between ownership and the quality of care.

Suggested Citation

  • Hjelmar, Ulf & Bhatti, Yosef & Petersen, Ole Helby & Rostgaard, Tine & Vrangbæk, Karsten, 2018. "Public/private ownership and quality of care: Evidence from Danish nursing homes," Social Science & Medicine, Elsevier, vol. 216(C), pages 41-49.
    • Handle: RePEc:eee:socmed:v:216:y:2018:i:c:p:41-49
    DOI: 10.1016/j.socscimed.2018.09.029
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    References listed on IDEAS

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    1. Barron, David N. & West, Elizabeth, 2017. "The quasi-market for adult residential care in the UK: Do for-profit, not-for-profit or public sector residential care and nursing homes provide better quality care?," Social Science & Medicine, Elsevier, vol. 179(C), pages 137-146.
    2. Chou, Shin-Yi, 2002. "Asymmetric information, ownership and quality of care: an empirical analysis of nursing homes," Journal of Health Economics, Elsevier, vol. 21(2), pages 293-311, March.
    3. Grabowski, David C. & Feng, Zhanlian & Hirth, Richard & Rahman, Momotazur & Mor, Vincent, 2013. "Effect of nursing home ownership on the quality of post-acute care: An instrumental variables approach," Journal of Health Economics, Elsevier, vol. 32(1), pages 12-21.
    4. José M. Alonso & Judith Clifton & Daniel Díaz-Fuentes, 2015. "Did New Public Management Matter? An empirical analysis of the outsourcing and decentralization effects on public sector size," Public Management Review, Taylor & Francis Journals, vol. 17(5), pages 643-660, May.
    5. Juliette Malley & José‐Luis Fernández, 2010. "Measuring Quality In Social Care Services: Theory And Practice," Annals of Public and Cooperative Economics, Wiley Blackwell, vol. 81(4), pages 559-582, December.
    6. Propper, Carol, 2018. "Competition in health care: lessons from the English experience," Health Economics, Policy and Law, Cambridge University Press, vol. 13(3-4), pages 492-508, July.
    7. Stolt, Ragnar & Blomqvist, Paula & Winblad, Ulrika, 2011. "Privatization of social services: Quality differences in Swedish elderly care," Social Science & Medicine, Elsevier, vol. 72(4), pages 560-567, February.
    8. Richard Hirth & David Grabowski & Zhanlian Feng & Momotazur Rahman & Vincent Mor, 2014. "Effect of nursing home ownership on hospitalization of long-stay residents: an instrumental variables approach," International Journal of Health Economics and Management, Springer, vol. 14(1), pages 1-18, March.
    9. Lisa A Ronald & Margaret J McGregor & Charlene Harrington & Allyson Pollock & Joel Lexchin, 2016. "Observational Evidence of For-Profit Delivery and Inferior Nursing Home Care: When Is There Enough Evidence for Policy Change?," PLOS Medicine, Public Library of Science, vol. 13(4), pages 1-12, April.
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    2. Yong, Jongsay & Yang, Ou & Zhang, Yuting & Scott, Anthony, 2021. "Ownership, quality and prices of nursing homes in Australia: Why greater private sector participation did not improve performance," Health Policy, Elsevier, vol. 125(11), pages 1475-1481.

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