title: Levelling the playing field? Exploring the implications of managed competition for voluntary sector providers of long-term care in small town Ontario.
abstract: This paper considers how long-term care restructuring, under the rubric of managed competition, has increased pressure on voluntary sector providers of long-term care to elderly populations in small, rural places. Drawing on in-depth interviews with key-informants from non-profit organizations, we present a case study set in rural Ontario to develop a situated understanding of the impact of restructuring on voluntary sector providers of long-term care. We contend that managed competition (underway in Ontario since 1995) has constrained providers, eroded service choices, and reduced access to long-term care in rural areas leaving rural populations more disadvantaged than ever before when it comes to public service provisioning.
authors.affiliation: Department of Geography and Centre on Aging, University of Victoria, PO BOX 3050 STN CSC, Victoria, British Columbia, Canada V8W 3P5.
authors.forename: Denise
authors.initials: D
authors.lastname: Cloutier-Fisher
authors.forename: Mark W
authors.initials: MW
authors.lastname: Skinner
mesh_terms: D006801:Humans; D007407:Interviews as Topic; D008134:Long-Term Care; D018854:Managed Competition; D009735:Nursing Homes; D009864:Ontario; D012424:Rural Population; D014838:Volunteers