Abstract

Spain has made a significant effort in expanding its old care system, mainly in traditional services as institutional care. But that expansion has not been uniform throughout the country. Depending on the regional policy and public funding, level of nursing-home coverage and types of centres diverge spatially. Nowadays private (enterprises and non-profit) nursing homes have risen. And, unfortunately, it appears differences in costs and quality among the supply of institutional services.

Objectives: To show how it functions a non-profit group of nursing homes located in Valencian Region (Spain) and figure out its main costs and quality features. Secondly to compare these costs data with the public financial support they received.

Data and methods: Data collected from a qualitative study (two rounds of interviews to a group of centre managers) and two quantitative surveys to LARES C.V. (non-profit Valencian Association of nursing-homes). We collect information from a sample of 21 centres with 1.161 places.

Results: Qualitative: a decrease in funding sources, mainly public ones, but managers want to maintain their alternative model of care without reducing employment and quality. In costs: Daily cost per user in 2011 is 56.48€ and the costliest section is direct care. This cost is higher than the regional subsidy and the national subsidy that nursing home centres received. In quality: strong weight of solidarity from the civil volunteers and religious nuns, civil and enterprises donations, and the special type of centers and their location.

Policy implications: Non-profit nursing homes in Valencian regions are demanding more public financial support to regional government to afford their growing costs and its quality of services. It seems important for policy designers to realize that with their present funding system to these non profit nursing homes and other private centres it will be not possible to sustain the institutional care model. Some centres will close or reduce their employees with direct effects on the amount and quality of services

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