Research conducted by the University of Gothenburg has highlighted that Sweden’s top-performing long-term residential care homes for older adults, which are not managed by municipal authorities, are predominantly operated by non-profit organisations. The debate surrounding the privatisation of Swedish welfare, particularly about elderly care, has been ongoing for years. Presently, around 20 per cent of all residential care homes in Sweden are operated by entities other than municipal bodies. Recent studies show a notable variance in the quality of care these entities provide to the elderly population.
The study reveals that non-profit organisations deliver the highest quality of care in residential facilities. On the other hand, the quality of care is found to be lowest in homes managed by publicly listed companies and private equity firms. The residential care homes operated by private limited liability companies are occupying the middle ground in terms of care quality. Rasmus Broms, a political scientist, along with his colleagues Carl Dahlström and Marina Nistotskaya, explored the impact of operational models on the quality of care in non-municipal residential care homes across Sweden. Their research compared the performance across four types of operational models: non-profit organisations, private limited companies, publicly traded companies, and private equity firms. The parameters for their comparison included staff-to-resident ratios, nurse availability, staff educational qualifications, resident satisfaction, and the frequency of updates to the homes’ action plans. Their analysis covered 2,639 non-municipal nursing homes from 2012 to 2019.
The research’s findings indicate that non-profit entities, often driven by ideological motives, consistently offer the highest quality of care for the elderly in Sweden, primarily because they reinvest any financial surpluses back into their services rather than distributing profits.
“These homes showcase the highest ratios of staff to residents, a greater number of nurses, the most qualified caregiving staff in terms of educational background, and the highest levels of resident satisfaction,” the research notes.
Private companies were observed to offer superior care quality among the for-profit care providers. These homes stand out for their high staff-to-resident ratios and generally more educated staff, unlike those operated by publicly traded or private equity-owned companies.
Broms elaborates, “While our study did not delve deeply into municipally operated facilities, we found that the quality of municipal residential care homes typically falls between those operated by non-profits and private companies. Our analysis underscores that non-municipal entities are capable of providing high-quality welfare services, although the quality significantly varies. This variation is an important consideration for municipalities when outsourcing the operation of these homes.”
More information: Rasmus Broms, Carl Dahlström et al, Provider Ownership and Indicators of Service Quality: Evidence from Swedish Residential Care Homes, Journal of Public Administration Research and Theory. DOI: 10.1093/jopart/muad002
Journal information: Journal of Public Administration Research and Theory Provided by University of Gothenburg
