The Effect of Perception Towards Environmental Turbulence on Person-Centered Care (PCC) in Nursing Home: A Comparative Study between Sole Proprietors and Nonprofit Corporations

Background/Purpose: The Long-Term Care Insurance Scheme was introduced by the South Korean government in 2008. Thereafter, the patient's quality of life has largely been varied by the nursing home providers and their capacity. Further, a significant number of sole proprietorships for-profit in the market has increased and a service quality issue has been raised due to reducing operating costs. There is a high level of competition for nursing homes in South Korea due to the large number of nursing homes in comparison to the number of patients. Generally, sole proprietors (SP) and nonprofit corporations (NP) are more sensitive to market changes in order to attract patients. Several studies have examined the effects of the market environment and service quality on nursing homes, but few studies have been done to explore the combined effects of market environment, Person-Centered Care (PCC), and ownership type. The purpose of this study is to compile a comparative analysis of managers' market environmental turbulence perception of PCCs by facility ownership. The specific questions are 1) Is environmental change perceived differently by facility ownership? 2) Does managers' market environmental turbulence perception by the facility ownership influence PCC; and 3) Are there sub-dimensions of environmental turbulence that affect PCC?

Methods: The study used a survey conducted by the Center for Social Research on Person-Centered Care in Nursing Homes at Yonsei University, South Korea. The unit of analysis is an organization and survey was conducted targeting managers of 2,752 facilities nationwide. The 268(9.7%) data were selected for final sample (54.5% of SP and 45.5% of NP). Care quality was measured by using the PCC scale. The managers' perception of environmental turbulence was measured by the Environment Turbulence, and subscales such as Technological turbulence, Market turbulence, and competitive intensity were used.

Results: According to multiple regression analysis, PCC at both facilities appears to be significantly impacted by managers' perception of market turbulence. In terms of environment turbulence, technological turbulence had a positive effect on PCC for both ownerships (SP β=.324, p<.001, NP β=.208, p<.05). There was a significantly higher level of PCC with a higher level of SP managers' market turbulence perception, which reflects customer needs (β=.257, p<.01). In light of these results, it can be interpreted that sole proprietors are more sensitive to client needs since they are smaller than nonprofit corporations and have fewer service programs.

Implications: The main results show that the perception of environmental turbulence of nursing home managers has a significant effect on increasing PCC. Hence, nursing home managers should be provided with a variety of information related to market changes so that they will be aware of environmental changes. According to the results, the perception of Market Turbulence, which is a subscale of the perception of Environmental Turbulence, has an effect on PCC. In this regard, it is important to provide a variety of information to a sole proprietor who is lacking information about market needs. Finally, both facilities should consistently monitor market conditions and develop and execute strategies aimed at enhancing PCC.