Researchers examine nursing home quality of care

Not-for-profit homes in the United States generally provide better care than their for-profit cousins, says a new study by University of Toronto researchers.

Michael Hillmer, a PhD candidate in health policy at U of T and lead author of the study, and his co-authors examined about 40 comparisons of nursing home care - only one of which was in Canada - published between 1990 and 2002. Their findings are reported in the April 2005 issue of Medical Care Research and Review.

"It was striking to find that so few Canadian studies have been done so far on an important area, one that is heavily studied in the U.S.," says Hillmer.

The researchers reviewed data on factors such as staffing, use of restraints and pressure ulcers. Results indicate that not-for-profit homes south-of-the-border generally perform better than for-profit homes, especially when it comes to measures of patient care. At their worst, not-for-profit homes were no different than their for-profit counterparts.

Patients in for-profit homes tended to have higher rates of pressure ulcers, says Hillmer. There was also generally more use of psychoactive medications to subdue patients and greater use of physical restraints.

"We don't really know what it is about not-for-profit homes that allows them to perform better," says Hillmer. "It could be as simple as them being required to put any profits back into the homes."

He strongly cautions, however, against drawing the same conclusions in Canada, since not enough study has been done on the Canadian situation.