title: Managing competition in the countryside: Non-profit and for-profit perceptions of long-term care in rural Ontario.
abstract: This paper contributes to the current debates surrounding private delivery of health care services by addressing the distinctive challenges, constraints and opportunities facing for-profit and non-profit providers of long-term care in rural and small town settings. It focuses on the empirical case of Ontario, Canada where extensive restructuring of long-term care, under the rubric of managed competition, has been underway since the mid-1990s. In-depth interviews with 72 representatives from local governments, public health institutions and authorities, for-profit and non-profit organisations, and community groups during July 2003 to December 2003 form the platform for a qualitative analysis of the implications of managed competition as it relates to the provision of long-term care in the countryside. The results suggest that the introduction and implementation of managed competition has accentuated the problems of service provision in rural communities, and that the long-standing issues of caregiving in rural situations transcend the differences, perceived or otherwise, between for-profit and non-profit provision. Understanding the implications of market-oriented long-term care restructuring initiatives for providers, and their clients, in rural situations requires a re-focussing of research beyond the for- versus non-profit dichotomy.
authors.affiliation: Department of Geography, Trent University, 1600 West Bank Drive, Peterborough, Ont., Canada K9J 7B8. markskinner@trentu.ca
authors.forename: Mark W
authors.initials: MW
authors.lastname: Skinner
authors.forename: Mark W
authors.initials: MW
authors.lastname: Rosenberg
mesh_terms: D000368:Aged; D004465:Economic Competition / Q000458:organization & administration*; D006707:Homes for the Aged / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic; D008134:Long-Term Care; D009313:National Health Programs; D009864:Ontario; D012424:Rural Population