Contractual arrangements for geriatric care in private nursing

This paper is concerned with the provision of long-stay care for the elderly in a district Health Authority. The major alternative forms of care compared are NHS long-stay hospital and the use of "contract beds" in private nursing homes. "Contract beds" are beds occupied by NHS patients and paid for by the Health Authority. The study was based on one Authority which had the greatest provision of contracted beds throughout England. This study shows that for this locality the average costs of caring for people by contracting-out arrangements are approximately 33% below costs of the local long-stay hospital even allowing for the fact that patients in the long-stay hospital are on the whole more dependent than those in contract beds. The study also reports the general professional controversy which surrounds the definition and measurement of standards of care in long-stay facilities for the care of the elderly, but, since it is only a pilot study, does not contain any evidence of the effects of different forms or standards of care on changes in the state of health of patients. The general tentative conclusions of the study are that the existing rather crude evidence suggests that the provision of care in contract beds is an efficient alternative to long-stay hospital care.