The goal of this study was to examine differences in the quality and operational costs of residential care for people with mental retardation, comparing governmental, public and private facilities under the auspices of the Ministry of Social Affairs and Social Services. The study was conducted in light of the controversy and public debate regarding the quality and efficiency of facilities with different ownerships.
Quality of care was examined by means of five RAF-based questionnaires, which were developed jointly by the Myers-JDC-Brookdale Institute and the Ministry’s Division of Services for Persons with Development Disabilities and which rest on international literature and the standards and experience of the Division. The study examined eight key areas of quality: activities, living conditions, working procedures, manpower, buildings and maintenance, health, residents’ attitudes to specific aspects, and to overall aspects, of life in residential care. Operational costs were examined by means of the payments transferred to the care facilities by the Ministry.
The study revealed:
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According to the variables examined, the differences in quality between the three types of ownerships were found to be relatively small.
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The differences are not uniform across all the areas examined; each type has an advantage in some area.
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There is variation also among facilities under the same type of ownership; for each type, some of the facilities are of a higher quality than others.
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The cost of the private and public facilities is similar, but the cost of the government facilities is 42% higher than the private and 55% higher than the public facilities.
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This means that the higher cost of government facilities does not translate into an advantage in quality.
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A search of the Israeli and international literature revealed no study that examined the link between quality and cost with regard to residential facilities for persons with developmental disability, thus there is no comparative basis for our findings.
The study highlights the importance of empirically examining the differences between types of ownership, which can contribute to the discourse on privatization in general and in specific contexts.
The study was commissioned and funded by the Ministry of Social Services’ Division for Research, Planning and Training.
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