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Education and career path of French nursing home managers : impact on their human resources practices

  • Joël, Marie-Eve
  • Sibille, Romain
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    In France, more than 75% of the establishments spec ialized in the care for dependant elderly people are EHPADs (Establishments with housing for dependa nt and elderly people). These structures were created with the aim to rationalize the offer in this sector, but remain economically inefficient. Besides the fact that private and for-profit EHPADs would be more efficient, the studies devoted to the efficiency of these nursing homes do not allow to comprehend the actual causes explaining this situation. Throughout this article, we attempt to open the EHPAD’s black box in order to identify the differences in the production’s organization from which the inefficiencies could originate. We hypothesize that EHPAD managers have different pref erences, correlated with their professional characteristics, which would explain their managing strategies, especially concerning human resources. The results of an original survey among a sample of EHPAD managers focused on management practice matched to the EHPA2011 survey were mobilized in the testing of this relation. It first appears that the directors adopt different strategies to optimize the management of their hum an resources. Three decisive points concerning the pol icy for optimizing personnel management were studied: organizing the nurses’ timetables in ten-hour days versus maintaining a traditional organization in 7-hour days, introducing a regular attendance bonus versus not integrating this bonus in the form of remuneration, proposing diploma courses versus only offering short training courses. Probit models were used to explain the existence of different behaviors. In all three cases, the choices are determined by the managers’ professional characteristics, notably their training. These results open up new perspectives for public authorities to improve the efficiency of EHPADs and the quality of the service they have to offer.

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    Paper provided by Paris Dauphine University in its series Economics Papers from University Paris Dauphine with number 123456789/11700.

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    Date of creation: Sep 2013
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    Handle: RePEc:dau:papers:123456789/11700
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    1. Kris Knox & Eric Blankmeyer & J. Stutzman, 2007. "Technical efficiency in texas nursing facilities: A stochastic production frontier approach," Journal of Economics and Finance, Springer, vol. 31(1), pages 75-86, March.
    2. Niccie L. McKay, 1988. "An Econometric Analysis of Costs and Scale Economies in the Nursing Home Industry," Journal of Human Resources, University of Wisconsin Press, vol. 23(1), pages 57-75.
    3. Vitaliano, Donald F. & Toren, Mark, 1994. "Cost and efficiency in nursing homes: a stochastic frontier approach," Journal of Health Economics, Elsevier, vol. 13(3), pages 281-300, October.
    4. Meiland, Franka J. M. & Danse, Jos A. C. & Hoos, Aloysia M. & Wendte, Johannes F. & Gunning-Schepers, Louise J., 1996. "The use of the waiting list in a fair selection of patients for nursing home care," Health Policy, Elsevier, vol. 38(1), pages 1-11, October.
    5. Mehdi Farsi & Massimo Filippini, 2004. "An Empirical Analysis of Cost Efficiency in Non-profit and Public Nursing Homes," Annals of Public and Cooperative Economics, Wiley Blackwell, vol. 75(3), pages 339-365, 09.
    6. Nyman, John A. & Connor, Robert A., 1994. "Do case-mix adjusted nursing home reimbursements actually reflect costs? Minnesota's experience," Journal of Health Economics, Elsevier, vol. 13(2), pages 145-162, July.
    7. Furubotn, Eirik G & Pejovich, Svetozar, 1972. "Property Rights and Economic Theory: A Survey of Recent Literature," Journal of Economic Literature, American Economic Association, vol. 10(4), pages 1137-62, December.
    8. B. Dervaux & H. Leleu & H. Nogues & V. Valdmanis, 2006. "Assessing french nursing home efficiency : an indirect approach via budget-constrained DEA models," Post-Print hal-00282888, HAL.
    9. Nyman, John A & Bricker, Dennis L, 1989. "Profit Incentives and Technical Efficiency in the Production of Nursing Home Care," The Review of Economics and Statistics, MIT Press, vol. 71(4), pages 586-94, November.
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