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The price of placements in residential and nursing home care: the effects of contracts and competition

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  • Julien Forder
  • Ann Netten

Abstract

A variety of contract types are used in the placement of elderly people in residential and nursing care homes in the UK. Contracts vary according to how and when providers are paid. Among other things, prices can be made contingent on the total quantity of service to be purchased and on production cost characteristics. They can be determined at the time of placement or in advance. The primary objective of this paper is to assess the impact of contract choices on the price of placements. Regression analysis was conducted on a final sample of 1780 publicly funded placements made in 18 local authorities in the UK over a 6‐month period ending in early 1996. Controlling factors included in the price analysis were production cost indicators and those measuring market competitiveness. Choices of both quantity and cost contingent contracts were found to be significantly associated with placement prices. The findings support the hypothesis that contract payment arrangements have different risk, insurance and information properties, and so have implications for the performance of residential care providers. Copyright © 2000 John Wiley & Sons, Ltd.

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  • Julien Forder & Ann Netten, 2000. "The price of placements in residential and nursing home care: the effects of contracts and competition," Health Economics, John Wiley & Sons, Ltd., vol. 9(7), pages 643-657, October.
    • Handle: RePEc:wly:hlthec:v:9:y:2000:i:7:p:643-657
    DOI: 10.1002/1099-1050(200010)9:7<643::AID-HEC528>3.0.CO;2-X
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    1. Ferran Espuny Pujol & Ruth Hancock & Morten Hviid & Marcello Morciano & Stephen Pudney, 2021. "Market concentration, supply, quality and prices paid by local authorities in the English care home market," Health Economics, John Wiley & Sons, Ltd., vol. 30(8), pages 1886-1909, August.
    2. David C. Grabowski & Edward C. Norton, 2012. "Nursing Home Quality of Care," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 29, Edward Elgar Publishing.
    3. Siciliani Luigi, 2013. "The Economics of Long-Term Care," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 14(2), pages 343-375, August.
    4. Bryan, Karen & Gage, Heather & Gilbert, Ken, 2006. "Delayed transfers of older people from hospital: Causes and policy implications," Health Policy, Elsevier, vol. 76(2), pages 194-201, April.
    5. Forder, Julien & Allan, Stephen, 2014. "The impact of competition on quality and prices in the English care homes market," Journal of Health Economics, Elsevier, vol. 34(C), pages 73-83.
    6. Martin, Cécile, 2014. "Concurrence, prix et qualité de la prise en charge en EHPAD en France : Analyses micro-économétriques," Economics Thesis from University Paris Dauphine, Paris Dauphine University, number 123456789/13712 edited by Dormont, Brigitte.

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