In the United States, two-thirds of nursing homes are investor-owned, for-profit businesses. But are they better than not-for-profit homes? The results of an analysis published today suggest that not-for-profit homes, overall, may provide higher quality care.

The paper, published online in the British Medical Journal, examined 82 studies carried out in the United States and Canada between 1965 to 2003. Forty studies showed significantly better quality in not-for-profit homes and three showed the quality was better in for-profit homes. The remaining studies, however, had mixed results, which suggests wide variability among institutions.

Nursing homes, whether for-profit or not-for-profit, vary substantially in their management styles, motivations and organizational behavior, the authors note. Thus, they wrote, the report is not a blanket judgment of all institutions. "Some for-profit institutions may provide excellent quality care, whereas some not-for-profit institutions may provide inferior quality care."

However, in the big picture, the analysis found that nursing home residents in the United States would receive 500,000 more hours of nursing care per day if all not-for-profit institutions provided all nursing home care.

Given the costs of nursing home care and the fears families have about the well-being of their loved ones, more research describing the qualities of superior nursing homes might be in order.