title: Complaints in for-profit, non-profit and public nursing homes in two Canadian provinces.
abstract: BACKGROUND
  Nursing homes provide long-term housing, support and nursing care to frail elders who are no longer able to function independently. Although studies conducted in the United States have demonstrated an association between for-profit ownership and inferior quality, relatively few Canadian studies have made performance comparisons with reference to type of ownership. Complaints are one proxy measure of performance in the nursing home setting. Our study goal was to determine whether there is an association between facility ownership and the frequency of nursing home complaints.
  
  
  METHODS
  We analyzed publicly available data on complaints, regulatory measures, facility ownership and size for 604 facilities in Ontario over 1 year (2007/08) and 62 facilities in British Columbia (Fraser Health region) over 4 years (2004-2008). All analyses were carried out at the facility level. Negative binomial regression analysis was used to assess the association between type of facility ownership and frequency of complaints.
  
  
  RESULTS
  The mean (standard deviation) number of verified/substantiated complaints per 100 beds per year in Ontario and Fraser Health was 0.45 (1.10) and 0.78 (1.63) respectively. Most complaints related to resident care. Complaints were more frequent in facilities with more citations, i.e., violations of the legislation or regulations governing a home, (Ontario) and inspection violations (Fraser Health). Compared with Ontario's for-profit chain facilities, adjusted incident rate ratios and 95% confidence intervals of verified complaints were 0.56 (0.27-1.16), 0.58 (0.34-1.00), 0.43 (0.21- 0.88), and 0.50 (0.30- 0.84) for for-profit single-site, non-profit, charitable, and public facilities respectively. In Fraser Health, the adjusted incident rate ratio of substantiated complaints in non-profit facilities compared with for-profit facilities was 0.18 (0.07-0.45).
  
  
  CONCLUSIONS
  Compared with for-profit chain facilities, non-profit, charitable and public facilities had significantly lower rates of complaints in Ontario. Likewise, in British Columbia's Fraser Health region, non-profit owned facilities had significantly lower rates of complaints compared with for-profit owned facilities.
authors.affiliation: Department of Family Practice, University of British Columbia, Room 713, 828 West 10th Avenue,Vancouver, BC V5Z 1L8, Canada. mrgret@mail.ubc.ca
authors.forename: Margaret J
authors.initials: MJ
authors.lastname: McGregor
authors.forename: Marcy
authors.initials: M
authors.lastname: Cohen
authors.forename: Catherine-Rose
authors.initials: CR
authors.lastname: Stocks-Rankin
authors.forename: Michelle B
authors.initials: MB
authors.lastname: Cox
authors.forename: Kia
authors.initials: K
authors.lastname: Salomons
authors.forename: Kimberlyn M
authors.initials: KM
authors.lastname: McGrail
authors.forename: Charmaine
authors.initials: C
authors.lastname: Spencer
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Ronald
authors.forename: Michael
authors.initials: M
authors.lastname: Schulzer
mesh_terms: D001955:British Columbia; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D033161:Government Regulation; D006291:Health Policy; D006801:Humans; D015994:Incidence; D009735:Nursing Homes / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D009864:Ontario; D009939:Organizations, Nonprofit / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*