Not-for-profit facilities found to deliver better care for commonly reported quality measures
06 aug 2009-- Not-for-profit nursing homes, on average, deliver higher quality care than for-profit nursing homes, although many factors influence this relation among individual institutions, according to a study published Aug. 4 in BMJ.
Vikram R. Comondore, M.D., of the University of British Columbia in Vancouver, Canada, and colleagues analyzed the results of 82 observational studies and randomized controlled trials that investigated quality of care in not-for-profit versus for-profit nursing homes from 1965 to 2003. The researchers note that 40 of the studies concluded that not-for-profit nursing homes provided higher quality care; three studies concluded that for-profit nursing homes did. The remaining studies had less consistent findings. The researchers also found that not-for-profit facilities delivered higher quality care than for-profit facilities for two of the four most commonly reported quality measures: lower pressure ulcer prevalence (odds ratio, 0.91) and more or higher quality staffing (ratio of effect, 1.11). Results also favored not-for-profit facilities for physical restraint use and fewer deficiencies in regulatory assessments, although those results were not statistically significant. "Although the average effect is clear, that effect probably varies substantially across situations," the authors write. "The variability is probably explained, in part, by a variety of factors that vary within categories of for-profit and not-for-profit homes, including management styles, motivations, and organizational behavior. Given their variability, the results do not imply a blanket judgment of all institutions."
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