For-Profit Nursing Homes in the Netherlands: What Factors ExplainTheir Rise?

摘要

This exploratory, mixed-methods study analyzes characteristics of the emergingfor-profit nursing home industry in the Netherlands and identifies theinterrelated set of factors (context, trends, and sector conditions) thatcontribute to its growth. Until recently, the Dutch nursing home sector reliedalmost exclusively on nonprofit providers. Even though profit distribution innursing home care is still banned, the for-profit nursing home sector isexpanding. The study uses economic theory on nonprofit organizations andmixed-form markets to understand this expansion. We find that changes in theregulatory framework have unlocked the potential of the for-profit nursing homesector, enabling for-profit nursing homes to circumvent the for-profit ban. Theexpansion of the for-profit sector was mainly driven by the low responsivenessof the nonprofit sector to increased and changed demands. For-profit providerstook advantage of this void. Moreover, they exploited “cream-skimming” potentialin the market and used the wider care system to reduce their labor costs byrelying on external specialist care. Another main driver was the access tofinancial capital from private investors (e.g., private equity firms).