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Quality of life in long-term care facilities: Private funded CHSLDs outperform public ones

Montreal, October 3, 2019 – Quality assessment visits of CHSLDs show a very wide gap between the results obtained by public facilities and private funded ones. The latter provide a far better quality of life than facilities run by the government.

According to a report obtained through an access to information request, of the 356 CHSLDs visited between April 2015 and March 2017:

  • The living environments of 64% of private funded CHSLDs were deemed “entirely adequate,” a proportion nearly four times higher than for public facilities;
  • Not a single private funded CHSLD was considered “worrisome”;
  • In contrast, only 17.6% of public facilities were considered to be “entirely adequate”;
  • Some 71% of public facilities were judged to provide an “acceptable” environment;
  • And 11.5% of public facilities were found to have a “worrisome” environment.

The report on the Department of Health’s assessment visits paints a comprehensive picture of the situation, since it covers a little over 85% of the province’s CHSLDs.

“What explains such a wide gap? It’s the entrepreneurial variable,” maintains Patrick Déry, Senior Associate Analyst at the MEI and author of the publication. “Entrepreneurship and private management are simply more efficient than public management.”

Private funded CHSLDs are subsidized by the government but run by entrepreneurs. They receive the same funding as public facilities and are subject to the same conditions: The clientele, accommodation costs, and working conditions are the same.

“The only difference is the way they are managed, which produces very different results both for users and for the government,” adds Mr. Déry. “Private funded CHSLDs also cost the government less. A study carried out in 1996 showed that operating costs per day of attendance were 26% higher in public facilities, excluding the clinical component.”

Indeed, this study found that entrepreneurial management of the private funded facilities saved the government $30 million a year. He also estimated that there would be a “minimum” of $125 million in additional savings if this method of management were extended across the CHSLD network.

“This shows that considerable sums could be saved if more efficient methods of management were adopted by even a portion of the hospital network, all while improving, in all likelihood, the quality of services provided to patients,” says the author.

These results should not surprise anyone. Over the years, examples have been noted in many countries with social democratic values where, with equal resources, entrepreneurial management has proven superior to public management in health care.

“Entrepreneurship within public health care systems, combined with universal coverage, has proven itself here and elsewhere. There is no reason not to make more use of it, whether for CHSLDs, for hospitals, or for other components of health care,” concludes Patrick Déry.

The Viewpoint entitled “Does Entrepreneurship Make a Difference in Health Care? The Case of Private Funded CHSLDs” was prepared by Patrick Déry, Senior Associate Analyst at the MEI. This publication is available on our website.

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The MEI is an independent public policy think tank. Through its publications and media appearances, the MEI stimulates debate on public policies in Quebec and across Canada by proposing reforms based on market principles and entrepreneurship.


Interview requests: Pascale Déry, Vice President, Communications and Development, MEI. Tel.: 514-273-0969 ext. 2233 / Cell: 514-502-6757 / Email: pdery@iedm.org

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