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Quality of care in for-profit and not-for-profit nursing homes
 — systematic review and meta-analysis
Author(s)Vikram R Comondore, P J Devereaux, Qi Zhou
Journal titleBritish Medical Journal, vol 339, no 7717, 15 August 2009
Pagespp 381-384
Sourcewww.bmj.com
KeywordsNursing homes ; Quality ; Management [care] ; Clinical surveys ; Literature reviews.
AnnotationA systematic review and meta-analysis of observational studies and randomised controlled trials compared quality of care in for-profit and not-for-profit nursing homes. A comprehensive search yielded 8827 citations, of which 956 were judged appropriate for full text review. Study characteristics and results of 82 articles that met inclusion criteria were summarised, and results for the four most frequently reported quality measures were pooled. Included studies reported results dating from 1965 to 2003. In 40 studies, all statistically significant comparisons favoured not-for-profit facilities; in three studies, all statistically significant comparisons favoured for-profit facilities; and the remaining studies had less consistent findings. Meta analyses suggested that not-for-profit facilities delivered higher quality care than did for-profit facilities for two of the four most frequently reported quality measures: more or higher quality staffing, and lower pressure ulcer prevalence. Non-significant results favouring not-for-profit homes were found for two other most frequently used measures: physical restraint use, and fewer deficiencies in governmental regulatory assessments. This systematic review and meta-analysis suggests that, on average, not-for-profit homes deliver higher quality care than do for-profit nursing homes. Many factors may, however, influence this relation in the case of individual institutions. A letter in response to this article by Gage et al, "More on quality of care", appears in issue 7720 (5 September 2009, p 530). (RH).
Accession NumberCPA-090902211 A
ClassmarkLHB: 59: QA: 3G: 64A *

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