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Privatization of social services: Quality differences in Swedish elderly care

Listed author(s):
  • Stolt, Ragnar
  • Blomqvist, Paula
  • Winblad, Ulrika
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    One of the major policy trends in recent decades has been the privatization of social services. This trend has also reached Sweden, a welfare state with health care and social service sectors that previously had almost no private providers. One of the most affected areas is elderly care, i.e. home-help services and residential care provided to citizens older than 65 years, where the proportion of private providers increased from 1% in 1990 to 16% in 2010. The ongoing privatization in Sweden and many other countries has raised important questions regarding the consequences of this policy transformation. In this paper, we present a cross-sectional study comparing the quality of services in private and public elderly care. Using statistics from 2007 displaying a variety of quality dimensions covering over 99% of all elderly care residents in Sweden, we were able to show that privatization is indeed associated with significant quality differences. Structural quality factors such as the number of employees per resident was significantly smaller (-9%) in private elderly care. On the other hand, the proportion of residents participating in the formulation of their care plan (+7%), the proportion of elderly with a reasonable duration between evening meal and breakfast (+15%), and the proportion of elderly offered different food alternatives (+26%) were significantly in favour of private contractors. Our conclusion is that private care providers seem to emphasize service aspects rather than structural prerequisites for good care.

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    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 72 (2011)
    Issue (Month): 4 (February)
    Pages: 560-567

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    Handle: RePEc:eee:socmed:v:72:y:2011:i:4:p:560-567
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    1. Hillel Schmid, 2003. "Rethinking the policy of contracting out Social Services to non-governmental organizations," Public Management Review, Taylor & Francis Journals, vol. 5(3), pages 307-323, September.
    2. Germà Bel & Mildred Warner, 2008. "Challenging Issues in Local Privatization," Environment and Planning C, , vol. 26(1), pages 104-109, February.
    3. Stolt, Ragnar & Winblad, Ulrika, 2009. "Mechanisms behind privatization: A case study of private growth in Swedish elderly care," Social Science & Medicine, Elsevier, vol. 68(5), pages 903-911, March.
    4. Jeffry M. Netter & William L. Megginson, 2001. "From State to Market: A Survey of Empirical Studies on Privatization," Journal of Economic Literature, American Economic Association, vol. 39(2), pages 321-389, June.
    5. Vining, Aidan R. & Globerman, Steven, 1999. "Contracting-out health care services: a conceptual framework," Health Policy, Elsevier, vol. 46(2), pages 77-96, January.
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