The role of the non‐profit sector in the efficiency of elderly social services: A bootstrap data envelopment analysis study

Social services for the elderly are becoming increasingly important in societies where the elderly population is growing and requires specific attention to ensure their well‐being. Within these services, nursing homes play a key role, and it is therefore vital to ensure efficient management with an assessment according to their characteristics, which identifies needs. Most of the available evidence has considered economic indicators to analyse their performance, whereas there are few studies that also consider quality and relate inputs with outputs. This paper identifies cross‐sectional indicators for the evaluation of nursing homes and also carries out an empirical analysis of efficiency using the data envelopment analysis methodology with the sample obtained from centres in the province of Valencia (Spain). Results show varying levels of efficiency across ownership types, with non‐profit centres demonstrating the highest average efficiency scores (0.54 under constant returns to scale and 0.61 under variable returns to scale), followed by private centres (0.36 and 0.48, respectively) and public centres (0.31 and 0.39). These findings suggest significant potential for improving efficiency, particularly in public and private nursing homes, and highlight the relative strength of the non‐profit model in delivering elderly care services.