Utrecht University School of Governance, Utrecht, the Netherlands.
Scientific Center for Quality of Healthcare (IQ Healthcare), Radboud University Medical Center, Nijmegen, the Netherlands *Both the authors share first authorship of this article.
Int J Health Serv. 2020 Oct;50(4):431-443. doi: 10.1177/0020731420915658. Epub 2020 Apr 10.
This exploratory, mixed-methods study analyzes characteristics of the emerging for-profit nursing home industry in the Netherlands and identifies the interrelated set of factors (context, trends, and sector conditions) that contribute to its growth. Until recently, the Dutch nursing home sector relied almost exclusively on nonprofit providers. Even though profit distribution in nursing home care is still banned, the for-profit nursing home sector is expanding. The study uses economic theory on nonprofit organizations and mixed-form markets to understand this expansion. We find that changes in the regulatory framework have unlocked the potential of the for-profit nursing home sector, enabling for-profit nursing homes to circumvent the for-profit ban. The expansion of the for-profit sector was mainly driven by the low responsiveness of the nonprofit sector to increased and changed demands. For-profit providers took advantage of this void. Moreover, they exploited "cream-skimming" potential in the market and used the wider care system to reduce their labor costs by relying on external specialist care. Another main driver was the access to financial capital from private investors (e.g., private equity firms).
本探索性、混合方法研究分析了荷兰新兴营利性养老院行业的特征，并确定了促成其增长的一系列相互关联的因素（背景、趋势和行业条件）。直到最近，荷兰养老院行业几乎完全依赖非营利性提供商。尽管在养老院护理中仍然禁止利润分配，但营利性养老院行业正在扩张。该研究利用非营利组织和混合形式市场的经济理论来理解这种扩张。我们发现，监管框架的变化释放了营利性养老院行业的潜力，使营利性养老院能够规避营利性禁令。营利性部门的扩张主要是由于非营利部门对增加和变化的需求反应迟钝。营利性供应商利用了这一空白。此外，他们利用了市场的“择优筛选”潜力，并利用更广泛的护理系统，通过依赖外部专业护理来降低劳动力成本。另一个主要驱动因素是私人投资者（如私募股权公司）获得金融资本。
