Clarfield A Mark, Ginsberg Gary, Rasooly Iris, Levi Sara, Gindin Jacob, Dwolatzky Tzvi
Department of Geriatrics, Soroka University Hospital, Ben-Gurion University of the Negev, Beersheva, Israel.
Arch Gerontol Geriatr. 2009 Mar-Apr;48(2):167-72. doi: 10.1016/j.archger.2008.01.001. Epub 2008 Mar 4.
There has long been concern whether care is better in for-profit (FP) or not-for-profit (NFP) nursing homes (NHs). In order to answer this question in the Israeli context, a cross-sectional study of quality was undertaken, as measured by the Ministry of Health (MoH) assessment teams. We examined a convenience sample of 127 NHs (48 NFP, 79 FP), comprising approximately three quarters of Israel's 193 such institutions at the time of the study (1998-2001). A 100-point composite scale was designed derived from the detailed assessments of seven different professions. The quality of care on average was better in NFP (67/100 points) compared to FP (55/100 points) institutions (p<0.01). This differential was maintained even after adjusting for potential confounders such as the daily rate paid, institutional size and staffing levels. While homes belonging to both sectors were to be found among those receiving good to excellent grades, only FPs received lower quality scores. We conclude that in Israel, as in many other jurisdictions studied, FP NHs provide poorer care than NFPs, possibly due to a conflict between the demands of patient care and the desire to maximize profits in the FP institutions.
长期以来，人们一直关注营利性（FP）和非营利性（NFP）养老院的护理质量是否更好。为了在以色列的背景下回答这个问题，我们进行了一项质量横断面研究，由卫生部（MoH）评估团队进行测量。我们检查了127家养老院的便利样本（48家非营利性，79家营利性），约占研究期间（1998 - 2001年）以色列193家此类机构的四分之三。根据七个不同专业的详细评估设计了一个100分的综合量表。非营利性机构的平均护理质量（67/100分）优于营利性机构（55/100分）（p<0.01）。即使在调整了潜在的混杂因素，如每日收费、机构规模和人员配备水平后，这种差异仍然存在。虽然在获得良好到优秀等级的机构中都能找到这两个部门的养老院，但只有营利性养老院获得较低的质量分数。我们得出结论，在以色列，与许多其他研究过的司法管辖区一样，营利性养老院提供的护理比非营利性养老院差，这可能是由于患者护理需求与营利性机构追求利润最大化之间的冲突。
