For Profit or Not? Study Says Think "Not" When Considering Nursing Homes
Can you expect your loved ones to get better care when you put them in a for-profit nursing home or in a not-for profit home? Intuitively, given the competitive market place, you'd expect for-profits to do a better job for your money, but a recent study of homes in the United States and Canada, done by a group of mostly Canadian doctors and published in the British Medical Journal, suggests the not-for-profits provide higher quality of care.
The study cautions, however, that it is an overview and many factors may influence quality in the case of individual institutions.
The paper's 11 authors reviewed 8827 studies that had been done of the quality of care in for-profit versus not-for-profit nursing homes between 1965 and 2003. Of these, they decided 956 should be reviewed fully and they selected 82 articles to be included in their results.
The authors looked most closely at results for the four most frequently reported quality measures and found that in 40 of the articles, all significant comparisons favored not-for-profit facilities. In three, all comparisons favored for-profits, and the rest were less consistent.
Analyzing the combined results for the articles suggested not-for-profits delivered higher quality care in the categories of more or higher quality staffing and lower incidence of bed sores. The other two quality measures - physical restraint use and problems with government inspections - tended to favor not-for-profits but not by statistically significant amounts.
The study's authors noted that nursing homes, whether for-profit or not-for-profit, vary substantially in their management styles, motivations and organizational behavior, and their study, they said, is not a blanket judgment of all institutions. "Some for-profit institutions may provide excellent quality care, whereas some not-for-profit institutions may provide inferior quality care," they wrote.
Of course, such an analysis is only a broad background factor when we're looking for a home for our loved ones. However, the findings do remind us that the amount a home costs is not a guarantee of quality, and we do have to look closely at a lot of factors if we want a good result.
Michael Kosner, President
The Kosner Firm Chtd.
