SUBSTANTIVE ACCOUNTABILITY AND TRUST IN NURSING HOME SERVICES IN A COMPARATIVE PERSPECTIVE

TRUSTINCARE EXAMINES THE PERCEPTIONS AND ATTITUDES OF SERVICE BENEFICIARIES ON THE ACCOUNTABILITY AND TRUST IN NURSING HOME SERVICES. OUR STUDY MAKES AN IMPORTANT CONTRIBUTION TO ACCOUNTABILITY STUDIES, BY PROPOSING THE ANALYSIS OF SUBSTANTIVE ACCOUNTABILITY APPLIED TO NURSING HOME SERVICES.THIS REFERS TO THE PROVISION OF INFORMATION ON SPECIFIC ASPECTS RELATED TO THE QUALITY OF THEIR STRUCTURES, PROCESSES, AND OUTCOMES; AS WELL AS TO THE MECHANISMS USED TO EVALUATE AND SANCTION THE PERFORMANCE OF SUCH ELEMENTS. THEREFORE, IN ORDER TO GET AN ACCURATE ESTIMATE OF THE CURRENT REALITY OF NURSING HOMES, WE ASK RELATIVES OF CARE HOME RESIDENTS ABOUT THE EXPERIENCE OF THEIR RELATIVES, THE INFORMATION THEY ARE GIVEN ABOUT THE SERVICES PROVIDED, AND THEIR PERCEPTION ON THE CONTROL OF THE SERVICES. IN ADDITION, OUR STUDY SEEKS TO EMPIRICALLY TEST THE HYPOTHESIS THAT IF SERVICE PROVIDERS ARE MORE ACCOUNTABLE ABOUT THE SERVICES, THEIR BENEFICIARIES WILL TRUST THEM MORE. FINALLY, TRUSTINCARE ALSO INVESTIGATES THE VARIABLES THAT AFFECT THE PERCEPTIONS OF ACCOUNTABILITY OF NURSING HOME SERVICES, SUCH AS THE TYPE OF PROVIDER (PUBLIC, PRIVATE FOR-PROFIT AND NON-PROFIT), THE COMPETITION RATE, AND INEQUALITY OF THE USERS; AND THE EFFECT THAT DIFFERENT ARRANGEMENTS OF ACCOUNTABILITY AND REGULATION MODELS OF THE SERVICES HAVE ON THE TRUST IN THE SERVICES BY THEIR BENEFICIARIES. THE RESEARCH QUESTIONS ADDRESSED ARE THE FOLLOWING: - HOW DO RELATIVES OF CARE HOME RESIDENTS ASSESS THE ACCOUNTABILITY OF THE SERVICES? - WHICH FACTORS AFFECT SUCH PERCEPTION AND HOW DO THESE FACTORS PERFORM IN TIMES OF CRISES? - DOES ACCOUNTABILITY IN NURSING HOME SERVICES INFLUENCE THE LEVELS OF TRUST BY SERVICE BENEFICIARIES? HOW DO CORE CHARACTERISTICS OF NURSING HOMES, REGULATION MODELS AND ACCOUNTABILITY TOOLS IMPACT THE LEVEL OF TRUST THAT BENEFICIARIES HAVE ON SUCH SERVICES? TO ANSWER THESE QUESTIONS, WE WILL CONDUCT A SURVEY AND A CONJOINT SURVEY EXPERIMENT IN THE UK AND DENMARK. THESE SURVEYS WILL COMPLEMENT A SURVEY RECENTLY CONDUCTED IN SPAIN, WHICH WILL ALLOW US TO COMPARE PERCEPTIONS AND ATTITUDES ON ACCOUNTABILITY AND TRUST IN NURSING HOME SERVICES ACROSS WELFARE REGIMENS. RESEARCH ON NURSING HOME SERVICES PROVIDES EVIDENCE ON THE IMPORTANCE OF EXAMINING INFORMATION THAT IS ACCESSIBLE TO THE BENEFICIARIES OF THE SERVICES. THIS IS SO BECAUSE, FIRST, THE ELDERLY ARE A VULNERABLE GROUP THAT, GIVEN ITS POSITION IN THE LIFE CYCLE, DOES NOT ENJOY STRONG VOICES AND INDIVIDUAL AUTONOMY. AND SECOND, NURSING HOME SERVICES ARE PROVIDED BEHIND CLOSED DOORS WHEN COMPARED TO OTHER SERVICES. THESE TWO ASPECTS EMPHASIZE THE NEED FOR GREATER OPENNESS AND CONTROL FOR THE GENERAL PUBLIC AND BY THE SERVICE BENEFICIARIES (THE DIRECT USERS AND THEIR RELATIVES). SINCE THE CONSEQUENCES OF COVID-19 HAVE REFLECTED THE IMPORTANCE OF CARRYING OUT A SUBSTANTIAL REFORM OF THE SECTOR, OUR STUDY CONTRIBUTES TO THIS DEBATE BY EXAMINING THE FACTORS THAT ENHANCE THEIR ACCOUNTABILITY AND TRUST.