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For-profit Versus Not-for-profit Delivery of Long-term Care.


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Publication Topics

For-profit Versus Not-for-profit Delivery of Long-term Care.

Publication TypeJournal Article
Year of Publication2007
AuthorsMcGrail KM, McGregor MJ, Cohen M, Tate RB, Ronald LA
JournalCanadian Medical Association Journal
Start Page57
Citation Key211
Full Text

Public funds can be used to pay for health care services that are delivered either by for-profit or not-for profit agencies. A systematic review of patient outcomes in US hospitals by ownership status showed that not-for-profit hospitals tended to produce better results. Although there are no Canadian acute care hospitals in the for-profit sector, the issue of interest here is whether the same trend in outcomes applies to for-profit and not-for-profit ownership of long-term care facilities.
About 60% and 30% of all publicly funded long-term care beds in Ontario and British Columbia, respectively, are in for-profit institutions. The co-existence of for-profit and not-for-profit providers in the same province creates a "natural laboratory" for examining their differences. This is particularly true because the funding paid by the province to these facilities is tied to resident care requirements and thus the same amount is paid per standardized patient whether he or she is in a for-profit or a not-for-profit facility. Despite this, there has been relatively little Canadian research that examines the experiences of residents in these 2 types of facilities. Although there is an abundance of evidence from the United States demonstrating superior performance of the not-for-profit sector in measures of quality of care, there are claims that these findings have limited generalizability in Canada because of differences in the 2 countries' health care systems.
However, a few Canadian studies are now starting to provide a portrait of what public investment "buys" in for-profit and not-for-profit facilities.