SynthesisBMJ (Clinical research ed.)2009
Quality of care in for-profit and not-for-profit nursing homes: systematic review and meta-analysis.
Synthesis in BMJ (Clinical research ed.), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 117 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
117 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Psychosocial Work Environment and Well-Being of Direct-Care Staff Under Different Nursing Home Ownership Types: A Systematic Review.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2023Pooled it
- Pooled it
- Pharmaceutical policies: effects of regulating drug insurance schemes.The Cochrane database of systematic reviews · 2022Pooled it
- Pooled it
- Governance arrangements for health systems in low-income countries: an overview of systematic reviews.The Cochrane database of systematic reviews · 2017Pooled it
- Assessing quality of care of elderly patients using the ACOVE quality indicator set: a systematic review.PloS one · 2011Pooled it
- Moving Online: A Pilot Clinical Trial of the Changing Talk Online Communication Education for Nursing Home Staff.The Gerontologist · 2021Trial
- Educating Nursing Home Staff in Dementia Sensitive Communication: Impact on Antipsychotic Medication Use.Journal of the American Medical Directors Association · 2018Trial
- Trial
- An interdisciplinary knowledge translation intervention in long-term care: study protocol for the vitamin D and osteoporosis study (ViDOS) pilot cluster randomized controlled trial.Implementation science : IS · 2012Trial
- A randomized trial of the impact of survey design characteristics on response rates among nursing home providers.Evaluation & the health professions · 2011Trial
- Evaluating Differences in Disaster-Related Staffing for Nursing Homes by Ownership Status.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026Article
- Article
- Extreme Temperatures, Elevated PM2.5, and Acute Care Events Among Dual-Eligible Nursing Facility Residents.Journal of the American Geriatrics Society · 2026Article
- An Ethnographic Exploration of Social-Ecological Influences on Physical Activity in Care Homes for Older People.Health expectations : an international journal of public participation in health care and health policy · 2026Article
- Examining family and facility characteristics associated with family satisfaction in assisted living: the Minnesota Assisted Living Report Card project.Innovation in aging · 2026Article
- Variation in healthcare services utilization and continuity of care in long-term care facilities: a cross-sectional study.BMC health services research · 2025Article
- Association of Racial and Ethnic Composition with Staff Levels in Nursing Homes: 2013-2019.Journal of the American Medical Directors Association · 2025Article
- Does type of provider matter for staff well-being? a cross-sectional study of residential care home workers' job demands and resources.Work (Reading, Mass.) · 2025Article
- Institutional Betrayal in Inpatient Psychiatry: Effects on Trust and Engagement With Care.Psychiatric services (Washington, D.C.) · 2025Article
57 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
21 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare quality of care in for-profit and not-for-profit nursing homes.
designSystematic review and meta-analysis of observational studies and randomised controlled trials investigating quality of care in for-profit versus not-for-profit nursing homes.
resultsA comprehensive search yielded 8827 citations, of which 956 were judged appropriate for full text review. Study characteristics and results of 82 articles that met inclusion criteria were summarised, and results for the four most frequently reported quality measures were pooled. Included studies reported results dating from 1965 to 2003. In 40 studies, all statistically significant comparisons (P<0.05) favoured not-for-profit facilities; in three studies, all statistically significant comparisons favoured for-profit facilities, and the remaining studies had less consistent findings. Meta-analyses suggested that not-for-profit facilities delivered higher quality care than did for-profit facilities for two of the four most frequently reported quality measures: more or higher quality staffing (ratio of effect 1.11, 95% confidence interval 1.07 to 1.14, P<0.001) and lower pressure ulcer prevalence (odds ratio 0.91, 95% confidence interval 0.83 to 0.98, P=0.02). Non-significant results favouring not-for-profit homes were found for the two other most frequently used measures: physical restraint use (odds ratio 0.93, 0.82 to 1.05, P=0.25) and fewer deficiencies in governmental regulatory assessments (ratio of effect 0.90, 0.78 to 1.04, P=0.17).
conclusionsThis systematic review and meta-analysis of the evidence suggests that, on average, not-for-profit nursing homes deliver higher quality care than do for-profit nursing homes. Many factors may, however, influence this relation in the case of individual institutions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.