The Impact of the Mandatory Organizational Evaluation Program on Service Quality for Older Adults: A Case of Korean Nursing Homes

Background/Purpose: Since its inception in 1997, the Mandatory Organizational Evaluation Program (MOEP) of social service providers in Korea has been a source of controversy for its role in service quality management. Every social service provider is expected to participate in MOEP in every three years. Many criticize the MOEP stressing out its flaws in terms of such as of inappropriate evaluation criteria, lack of professional evaluators, and excessive paper works for the self-report preparing, etc. In case of nursing homes, which have grown to more than 2 thousand after the introduction of Long-term Care Insurance Scheme of 2008, are not different to other types of social service providers. The rapid growth of nursing homes has raised of service quality concern, while MOEP has been expected to improve the quality. On this background, a major question is whether the MOEP brings about service quality improvement or not. The purpose of this study is to analyzes the impact of the MOEP on service quality among nursing homes for older adults.

Methods: Data and Samples: The data is from a 「2020 National Survey on Person-Centered Care in Nursing Homes」 by the Center for Social Research at Yonsei University. The data consists of two parts; one is from online survey by using Survey Monkey, an online survey tool; the other is from membership information of web-site of the National Health Insurance Corporation (NHIC). Thus, the data is a combined format. For the online survey 559 out of 2,752 nursing homes responded (20.3 %). However, only 326 cases were analyzed for this study after eliminating 233, due to excessive non-response items, lack of operation period, and/or unidentifiable evaluation scores, etc.

Measures: The result score of the MOEP in 2018 was used as a key variable. The score was acquired from the NHIC website. The score is the sum of five categories such as institutional operation, environment and safety, residents’ rights, process of service provision, and service result.

Service quality was measured by using the person-centered care scale in Korean developed by Choi and Lee (2014) comprising a 30-item, 7-factor (autonomy, personhood, knowing the person, support relations, comfort care, working with residents, management structure) construct. It is a Likert-type scale ranging from 1 to 5, where 1 indicates ‘not at all’ and 5 indicates ‘strongly agree’.

Results: Multiple regression analysis shows that there is no evidence of the result score of the MOEP significantly affecting on service quality, person-centered care. Another finding indicates that the average service quality level was 3.94 out of 5 points. Among the control variables, the size of the workers (+) and competition intensity (+) appeared to have statistically significant influence on service quality.

Implications: Unlikely of the expectation that the MOEP will make possible service quality improvement, this study shows that the MOEP is not relevant to service quality in nursing homes for older adults. There is a great demand for further studies of the reasons why the MOEP has failed to improve service quality.