Harrington Charlene, Jacobsen Frode F, Panos Justin, Pollock Allyson, Sutaria Shailen, Szebehely Marta
Department of Social & Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.
Center for Care Research, Western Norway University of Applied Sciences, Bergen, Norway.
Health Serv Insights. 2017 Jun 8;10:1178632917710533. doi: 10.1177/1178632917710533. eCollection 2017.
This article presents cross-country comparisons of trends in for-profit nursing home chains in Canada, Norway, Sweden, United Kingdom, and the United States. Using public and private industry reports, the study describes ownership, corporate strategies, costs, and quality of the 5 largest for-profit chains in each country. The findings show that large for-profit nursing home chains are increasingly owned by private equity investors, have had many ownership changes over time, and have complex organizational structures. Large for-profit nursing home chains increasingly dominate the market and their strategies include the separation of property from operations, diversification, the expansion to many locations, and the use of tax havens. Generally, the chains have large revenues with high profit margins with some documented quality problems. The lack of adequate public information about the ownership, costs, and quality of services provided by nursing home chains is problematic in all the countries. The marketization of nursing home care poses new challenges to governments in collecting and reporting information to control costs as well as to ensure quality and public accountability.
本文呈现了加拿大、挪威、瑞典、英国和美国营利性养老院连锁机构的跨国趋势比较。该研究利用公共和私营行业报告，描述了每个国家最大的5家营利性连锁机构的所有权、企业战略、成本和质量。研究结果表明，大型营利性养老院连锁机构越来越多地由私募股权投资者所有，随着时间推移经历了多次所有权变更，并且拥有复杂的组织结构。大型营利性养老院连锁机构在市场中占据主导地位的趋势日益明显，其战略包括资产与运营分离、多元化、向多地扩张以及利用避税天堂。总体而言，这些连锁机构收入丰厚，利润率高，但存在一些记录在案的质量问题。在所有国家，养老院连锁机构的所有权、成本和所提供服务质量方面缺乏足够的公开信息都是个问题。养老院护理的市场化给各国政府在收集和报告信息以控制成本以及确保质量和公共问责方面带来了新挑战。
