Competition and service quality: Evidence from Swedish residential care homes

Against a backdrop of increased levels of marketization of welfare services in OECD countries, this article aims to shed light on the separate effects of private ownership and competition for the market on service quality. Using residential elder care homes in Sweden as our case, we leverage unique panel data of ownership and competition against a set of indicators, pertaining to the structure, process, and outcome dimensions of care quality. The main finding of our analyses is that competition for the market does surprisingly little for quality: private entrepreneurs perform neither better nor worse under stiff competition and the quality of care is approximately the same in those nursing homes that are exposed to the market as in those that are not.