Comparison of Nursing Home Financial Transparency and Accountability in Four Locations
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- 作者：Charlene Harrington ; Hugh Armstrong ; Mark Halladay…
- 关键词：Ownership ; Accountability ; Financing ; Transparency
- 刊名：Ageing International
- 出版年：2016
- 出版时间：March 2016
- 年：2016
- 卷：41
- 期：1
- 页码：17-39
- 全文大小：478 KB
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Hugh Armstrong (2)
Mark Halladay (1) (3)
Anders Kvale Havig (4)
Frode F. Jacobsen (5)
Martha MacDonald (6)
Justin Panos (7)
Kathy Pearsall (8)
Allyson Pollock (9)
Leslie Ross (10)
1. Department of Social & Behavioral Sciences, University of California, 3333 California Street Suite 455, San Francisco, CA, 94118, USA
2. Professor Emeritus of Social Work, Political Economy, and Sociology, Carleton University, Ottawa, K1S 5B6, Canada
3. School of Health and Human Sciences, University of Essex, 9 Hamilton Rd, Wivenhoe, Colchester, Essex, CO79DU, UK
4. Center for Care Research, Gjøvik University College, Teknologivn. 22, N- 2815, Gjovik, Norway
5. Center for Care Research, Bergen University College, P.O.Box 7030, N- 5020, Bergen, Norway
6. Economics Department, Saint Mary’s University, Halifax, NS, B3H 3C3, Canada
7. Programme in Social and Political Thought, York University, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
8. Concerned Friends of Ontario Citizens in Care Facilities, 140 Merton St., 2nd Floor, Toronto, ON, M4S 1A1, Canada
9. Queen Mary, University of London, London, UK
10. Institute for Health and Aging, University of California, 3333 California Street Suite 340, San Francisco, CA, 94118, USA - 刊物主题：Social Sciences, general; Aging;
- 出版者：Springer US
- ISSN：1936-606X
文摘
The marketization and privatization of nursing home care has grown in many countries along with expenditures. Using documents and government reports, this study explored three research questions about nursing homes in California, Ontario, England, and Norway. What were: (1) the contextual and privatization differences; (2) payment methods and trends in revenues and expenditures for direct care, administration, and profits; and (3) the financial reporting and accountability systems? The findings showed nursing homes were highly privatized in all locations except Norway. Revenues and expenditures increased steadily in all locations. Direct care services were lower in California and England where privatization was highest. Administrative costs were high especially in for-profit companies, except in Norway’s municipal nursing homes. Profit margins were generally not reported or under reported, but high margins were found in for-profits and chains where reports were available. Contrary to the hypothesis that financial transparency and accountability would increase with privatization, only California and the U.S. had developed detailed public financial reporting, although these reports could be improved. Ontario required detailed financial reporting except for administration and profits and the information was not publicly available. England and Norway had no public systems for financial reporting. None of the locations had cost controls on administration and profits, except for Medicaid administration controls in California. Policy makers need to focus on improvements in financial transparency and accountability to assure value for expenditures and to potentially improve quality.