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Does the Profit Motive Matter? COVID-19 Prevention and Management in Ontario Long-Term-Care Homes

We introduce evidence that for-profit long-term-care providers are associated with less successful outcomes in coronavirus disease 2019 outbreak management. We introduce two sets of theoretical arguments that predict variation in service quality by provider type: those that deal with the institution...

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Autores principales: Pue, Kristen, Westlake, Daniel, Jansen, Alix
Formato: Online Artículo Texto
Lenguaje:English
Publicado: University of Toronto Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9400825/
https://www.ncbi.nlm.nih.gov/pubmed/36039354
http://dx.doi.org/10.3138/cpp.2020-151
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author Pue, Kristen
Westlake, Daniel
Jansen, Alix
author_facet Pue, Kristen
Westlake, Daniel
Jansen, Alix
author_sort Pue, Kristen
collection PubMed
description We introduce evidence that for-profit long-term-care providers are associated with less successful outcomes in coronavirus disease 2019 outbreak management. We introduce two sets of theoretical arguments that predict variation in service quality by provider type: those that deal with the institution of contracting (innovative competition vs. erosive competition) and those that address organizational features of for-profit, non-profit, and government actors (profit seeking, cross-subsidization, and future investment). We contextualize these arguments through a discussion of how contracting operates in Ontario long-term care. That discussion leads us to exclude the institutional arguments while retaining the arguments about organizational features as our three hypotheses. Using outbreak data as of February 2021, we find that government-run long-term-care homes surpassed for-profit and non-profit homes in outbreak management, consistent with an earlier finding from Stall et al. (2020). Non-profit homes outperform for-profit homes but are outperformed by government-run homes. These results are consistent with the expectations derived from two theoretical arguments—profit seeking and cross-subsidization—and inconsistent with a third—capacity for future investment.
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spelling pubmed-94008252022-08-25 Does the Profit Motive Matter? COVID-19 Prevention and Management in Ontario Long-Term-Care Homes Pue, Kristen Westlake, Daniel Jansen, Alix Can Public Policy The COVID-19 Pandemic/La Pandémie de COVID-19 We introduce evidence that for-profit long-term-care providers are associated with less successful outcomes in coronavirus disease 2019 outbreak management. We introduce two sets of theoretical arguments that predict variation in service quality by provider type: those that deal with the institution of contracting (innovative competition vs. erosive competition) and those that address organizational features of for-profit, non-profit, and government actors (profit seeking, cross-subsidization, and future investment). We contextualize these arguments through a discussion of how contracting operates in Ontario long-term care. That discussion leads us to exclude the institutional arguments while retaining the arguments about organizational features as our three hypotheses. Using outbreak data as of February 2021, we find that government-run long-term-care homes surpassed for-profit and non-profit homes in outbreak management, consistent with an earlier finding from Stall et al. (2020). Non-profit homes outperform for-profit homes but are outperformed by government-run homes. These results are consistent with the expectations derived from two theoretical arguments—profit seeking and cross-subsidization—and inconsistent with a third—capacity for future investment. University of Toronto Press 2021-09-01 2021-03-28 /pmc/articles/PMC9400825/ /pubmed/36039354 http://dx.doi.org/10.3138/cpp.2020-151 Text en © Canadian Public Policy / Analyse de politiques This article is made available via the PMC Open Access Subset for reuse and analysis with acknowledgement of the original source.
spellingShingle The COVID-19 Pandemic/La Pandémie de COVID-19
Pue, Kristen
Westlake, Daniel
Jansen, Alix
Does the Profit Motive Matter? COVID-19 Prevention and Management in Ontario Long-Term-Care Homes
title Does the Profit Motive Matter? COVID-19 Prevention and Management in Ontario Long-Term-Care Homes
title_full Does the Profit Motive Matter? COVID-19 Prevention and Management in Ontario Long-Term-Care Homes
title_fullStr Does the Profit Motive Matter? COVID-19 Prevention and Management in Ontario Long-Term-Care Homes
title_full_unstemmed Does the Profit Motive Matter? COVID-19 Prevention and Management in Ontario Long-Term-Care Homes
title_short Does the Profit Motive Matter? COVID-19 Prevention and Management in Ontario Long-Term-Care Homes
title_sort does the profit motive matter? covid-19 prevention and management in ontario long-term-care homes
topic The COVID-19 Pandemic/La Pandémie de COVID-19
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9400825/
https://www.ncbi.nlm.nih.gov/pubmed/36039354
http://dx.doi.org/10.3138/cpp.2020-151
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