Examining the relationship between organizational structure, regulation, and quality outcomes in long-term care homes in Ontario
My thesis uses longitudinal data to examine relationships between organizational structure (e.g., ownership type, chain affiliation status, operation size), regulation, and quality outcomes in long-term care homes (LTCHs). The province of Ontario provides an ideal setting for this study: Ontario has the highest proportion of for-profit, chain-owned LTCHs in Canada and has witnessed significant change in its approaches to LTCH regulation and accountability in recent years. However, the question of whether and to what extent LTCH organizational structure affects resident-level quality outcomes in a highly regulated environment like Ontario’s has not been closely examined in the province (or in Canada), and there is a paucity of evidence on whether regulation contributes to changes in quality outcomes and if its effects vary with LTCH organizational structure. My thesis includes a systematic review of the evidence on the effects of regulation on quality outcomes in LTCHs, followed by two empirical chapters that employ a systems of equations approach to explore the complex relationships between organizational structure, regulation and quality outcomes.
Audrey Laporte, Peter C. Coyte, Colleen M. Flood, Walter Wodchis
BA combined major in Economics and Political Science, University of British Columbia MSc Health Services Research, Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto Currently PhD Candidate in Health Services Research, IHPME
Project Director, CIHR Institute of Health Services and Policy Research