McGregor Margaret J
Department of Family Practice, University of British Columbia, Family Physician, Mid-Main Community Health Centre.
Healthc Pap. 2011;10(4):30-4; discussion 58-62. doi: 10.12927/hcpap.2011.22188.
While Canadian provinces demonstrate considerable diversity of performance within the non-profit sector and further research is needed to better understand which non-profit models support the best quality, Canadian research has been generally consistent with US research in confirming a relationship between for-profit ownership and inferior quality. The quality concerns arising from public funding to the private for-profit residential long-term care sector are unlikely to be addressed by adopting tighter regulations. With the expansion of private for-profit delivery, the organizational goals of the regulator and the facilities being regulated become less aligned. The former is likely to move to a more deterrence-based model of regulation, which is costly, less effective and draws resources away from direct patient care.
虽然加拿大各省在非营利部门的表现存在很大差异,需要进一步研究以更好地理解哪种非营利模式能支持最佳质量,但加拿大的研究在证实营利性所有权与质量较差之间的关系方面总体上与美国的研究一致。向私营营利性机构提供公共资金用于长期护理服务所引发的质量问题,不太可能通过实施更严格的监管来解决。随着私营营利性服务的扩张,监管机构和受监管机构的组织目标变得不那么一致。前者可能会转向更基于威慑的监管模式,这种模式成本高昂、效果较差,还会将资源从直接的患者护理中抽离。