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Community-Based Home Support Agencies: Comparing the Quality of Care of Cooperative and Non-profit Organizations*

Published online by Cambridge University Press:  01 June 2009

Catherine Leviten-Reid*
Affiliation:
Centre for the Study of Co-operatives, University of Saskatchewan
Ann Hoyt
Affiliation:
School of Human Ecology, University of Wisconsin–Madison
*
Correspondence to: / Correspondance à : Catherine Leviten-Reid Centre for the Study of Co-operatives University of Saskatchewan 101 Diefenbaker Place Saskatoon, Saskatchewan S7N 5B8 Email: catherine.levitenreid@usask.ca.

Abstract

In the province of Québec, services focusing on the instrumental activities of daily living are delivered to seniors by a combination of non-profit organizations and cooperatives. But do these organizations perform differently? This study asks whether home support cooperatives deliver higher-quality care than non-profit home support agencies. The specific effects of consumer and worker participation on the board of directors are also tested. Data were collected in 2006 and 2007 from 831 individuals receiving home support services from nine cooperatives and nine non-profits. Two consumer-centered measures of quality were used: a summated, 39-point satisfaction score and a 4-point overall quality score. Data were analyzed using ordered logistic regression. Results show that although organizational type was not a predictor of the two quality outcomes, worker involvement in governance was positively associated with the satisfaction score, while consumer involvement was positively associated with the overall quality score.

Résumé

Au Québec, une combinaison d’organismes sans but lucratif et de coopératives offre des services d’entretien ménager, de préparation de repas et d’aide aux courses aux personnes âgées. Dans la présente étude, on pose la question suivante : les services offerts par les coopératives de services à domicile sont-ils de meilleure qualité que les services offerts par les organismes sans but lucratif? Cette étude permet également d’examiner les répercussions déterminées de la participation des bénéficiaires et des travailleurs et travailleuses au conseil d’administration. Les données ont été recueillies en 2006 et 2007 auprès de 831 personnes bénéficiaires de services à domicile, assurés par 9 coopératives et 9 organismes sans but lucratif. Deux instruments de mesure de la qualité centrés sur les bénéficiaires ont été utilisés : une échelle d’évaluation sommative de la qualité en 39 points et une note globale de qualité en 4 points. Les données ont été analysées par régression logistique. Les résultats révèlent que la structure organisationnelle n’est pas une variable explicative de la qualité, mais que la participation des travailleurs et des travailleuses au conseil d’administration est associée positivement à la note de satisfaction. De plus, la participation des bénéficiaires est associée positivement à la note de qualité globale.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2009

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Footnotes

*

We would like to thank Judith Bartfeld, Gary Green, Brent Hueth, and Roberta Riportella for their helpful feedback. Catherine Leviten Reid also acknowledges the funding sources that helped cover data collection costs. These include the School of Human Ecology, the Department of Consumer Science, and the Urban Cooperative Initiative, all at the University of Wisconsin–Madison. We would also like to thank those home support agencies and individuals who participated in this research.

References

Aharony, L., & Strasser, S. (1993). Patient satisfaction: What we know about and what we still need to explore. Medical Care Review 50(1), 4979.CrossRefGoogle ScholarPubMed
Allan, C., & Lovell, K. (2003). The effects of high performance work systems on employees in aged care. Labour & Industry (13)3, 217.Google Scholar
Allison, P.D. (2002). Missing data. Thousand Oaks, CA: Sage.CrossRefGoogle Scholar
Avis, M., Bond, M., & Arthur, A. (1997). Questioning patient satisfaction: An empirical investigation in two outpatient clinics. Social Science and Medicine 44(1), 8592.CrossRefGoogle Scholar
Bager, T. (1994). Isomorphic processes and the transformation of cooperatives. Annals of Public and Cooperative Economics 65(1), 179207.CrossRefGoogle Scholar
Benjamin, E.A. (2001). Consumer-directed services at home: A new model for persons with disabilities, Health Affairs 20(6), 8095.CrossRefGoogle Scholar
Benjamin, E.A., Matthias, R., & Franke, T.M. (2000). Comparing consumer-directed and agency models for providing supportive services at home. Health Services Research 35(1), 351366.Google ScholarPubMed
Ben-Ner, A., & Hoomissen, T.V. (1993). Nonprofit organizations in the mixed economy: A demand and supply analysis. Annals of Public and Cooperative Economics 62(4), 519550.CrossRefGoogle Scholar
Borzaga, C. (2001). Italy: The impressive development of social cooperatives in Italy. In Spear, R., Defourny, J., Favreau, L. & Laville, J. (Eds.) Tackling social exclusion in Europe: The contribution of the social economy. Burlington, VT: Ashgate.Google Scholar
Bozeman, B., & Bretschneider, S. (1994). The “publicness puzzle” in organization theory: A test of alternative explanations of differences between public and private organizations. Journal of Public Administration Research and Theory 4(2), 197223.Google Scholar
Chagnon, J. (2004). Portrait 2003 des entreprises en aide domestique. Québec: Développement Économique, Innovation et Exportation Québec.Google Scholar
Chantier de l’économie sociale. (2003) L’aide domestique: Tout un progrès! N.p.: author.Google Scholar
Clarke, L., & Estes, C.L. (1992) Sociological and economic theories of markets and nonprofits: Evidence from home health organizations. The American Journal of Sociology 97(4), 945969.CrossRefGoogle Scholar
Commission des normes du travail Québec. (2007). Wages. Retrieved August 31, 2007 from http://www.cnt.gouv.qc.ca/en/normes/salaire.aspGoogle Scholar
Cronin, J. Jr, Brady, M., & Hult, G.T. (2000) Assessing the effects of quality, value, and customer satisfaction on consumer behavioral intentions in service environments. Journal of Retailing 76(2), 193218.CrossRefGoogle Scholar
Daly, T. (2007). Out of place: Mediating health and social care in Ontario’s long-term care sector. Canadian Journal on Aging, 26(1), 6376.CrossRefGoogle ScholarPubMed
Dawson, S., & Surpin, R. (2001). Direct-care health workers: The unnecessary crisis in long-term care. N.p.: Domestic Strategy Group of the Aspen Institute.Google Scholar
Doran, D., & Pickard, J. (2004). Management and delivery of community nursing services in Ontario: Impact on the quality of care and the quality of worklife of community-based nurses. Toronto: University of Toronto.Google Scholar
Éditeur officiel du Québec. (2007). Loi sur les coopératives. Retrieved August 30, 2007 from http://www2.publicationsduquebec.gouv.qc.ca/dynamicSearch/telecharge.php?type=2&file=/C_67_2/C67_2.htmlGoogle Scholar
Eustis, N.N., & Fischer, L.R. (1994). The home care worker: On the frontline of quality. Generations 18, 4350.Google Scholar
Eustis, N.N., Kane, R.A., & Fischer, L.R. (1993). Home care quality and the home care worker: Beyond quality assurance as usual. The Gerontologist 33, 6473.CrossRefGoogle ScholarPubMed
Feldman, P.H. (1993). Work life improvements for home care workers: Impact and feasibility. The Gerontologist 33(1), 4754.CrossRefGoogle ScholarPubMed
Huisman, M. (2000). Imputation of missing item responses: Some simple techniques. Quality and Quantity 34(4), 331351.Google Scholar
Geron, S.M., Smith, K., Tennstedt, S., Jette, A., Chassler, D., & Kasten, L. (2000). The home care satisfaction measure. Journal of Gerontology 55B, S259S270.CrossRefGoogle Scholar
Glickman, L., Stocker, K., & Caro, F. (1997). Self–direction in home care for older people: A consumer’s perspective. Home Health Care Services Quarterly 16(1/2), 4154.CrossRefGoogle ScholarPubMed
Hall, J.A., Milburn, M.A. & Epstein, A.E. (1993). A causal model of health status and satisfaction with medical care.” Medical Care 31: 8494.CrossRefGoogle ScholarPubMed
Hyrkäs, K., & Paunonen, M. (2000). Patient satisfaction and research-related problems: Is triangulation the answer? Journal of Nursing Management 8, 237245.CrossRefGoogle ScholarPubMed
International Co-operative Alliance. (2009). Statement on the co-operative identity. Retrieved May 7 from http://www.ica.coop/coop/principles.html.Google Scholar
Jetté, C., & Lévesque, B. (2003). Les rapports de consommation et la participation des usagers. In Vaillancourt, Y., Aubry, F. & Jetté, C. (Eds.) L’économie sociale dans les services à domicile. Québec: Presses de l’Université du Québec.Google Scholar
Kahn, K. (2000). Quality care partners. New York: Paraprofessional Healthcare Institute.Google Scholar
Laville, J., Lévesque, B., & Mendell, M. (2007). The social economy: Diverse approaches and practices in Canada. In The social economy: Building inclusive economies. Paris: Organisation for Economic Co-operation and Development’s Local Economic and Employment Development (LEED) Programme.Google Scholar
MacDonald, S.E., NewburnCook, C.V., Schopflocher, D., & Richter, S. Addressing nonresponse bias in postal surveys. Public Health Nursing 26, 95105.CrossRefGoogle Scholar
Majee, W. (2007). Cooperatives and the creation of social capital: A case of rural cooperative home care. Unpublished doctoral dissertation, University of WisconsinMadison, WI.Google Scholar
Menard, Scott W. (2002) Applied logistic regression analysis. Thousand Oaks: Sage.CrossRefGoogle Scholar
Oka, M. (2000). A special consumer cooperative association nursing home. Journal of Aging and Social Policy 11(2/3), 99106.CrossRefGoogle ScholarPubMed
Parsons, M.E. (2004). The impact of the Eden Alternative on quality of life of nursing home residents. Unpublished doctoral dissertation, University of Nebraska–Lincoln, NE.Google Scholar
Quarter, J., Sousa, J., Richmond, B.J., & Carmichael, I. 2001. Comparing member-based organizations within a social economy framework. Nonprofit and Voluntary Sector Quarterly 30(2), 351375.CrossRefGoogle Scholar
Restakis, J., & Lindquist, E.A. (2001). Introduction: Government restructuring and the cooperative alternative. In Restakis, J. & Lindquist, E. (Eds.) The co-op alternative: Civil society and the future of public services. Toronto, Ontario: The Institute of Public Administration.Google Scholar
Shrive, F., Stuart, H., Quan, H., & Ghali, W.A. (2006). Dealing with missing data in a multi-question depression scale: A comparison of imputation methods. Medical Research Methodology 6, 57.CrossRefGoogle Scholar
Skinner, M.W., & Rosenberg, M.W. (2006). Managing competition in the countryside: Non-profit and for-profit perceptions of long-term care in rural Ontario. Social Science and Medicine 63(11), 28642876.CrossRefGoogle ScholarPubMed
Smaller World Communication. (2000). Development of a client satisfaction survey for CCAC clients. Richmond Hill, Ontario: Author.Google Scholar
Statistics Canada. (2006). 2006 Community Profiles. Retrieved January 12, 2009 from http://www12.statcan.ca/census-recensement/2006/dp-pd/prof/92-591/index.cfm?Lang=E)Google Scholar
Williams, B., Coyle, J., & Healy, D. (1998). The meaning of patient satisfaction: An explanation of high reported levels. Social Science and Medicine 47(9), 13511359.CrossRefGoogle ScholarPubMed
Yeatts, D., & Cready, C. (2007) Consequences of empowered CNA teams in nursing home settings: A longitudinal assessment. The Gerontologist 47(3), 323339.CrossRefGoogle ScholarPubMed