Motivation and commissioning: perceived and expressed motivations of care home providers
ABSTRACT Commissioning of social care for older people has seen major changes since the early 1990s. Considerable responsibility now rests with local authority staff, whose views of care home providers’ motivations, their perceived strengths and weaknesses as service providers, will have a bearing on commissioning decisions. We examine commissioners’ views of provider motivations in eight English local authorities and compare their perceived motivations with providers’ expressed motives. Data were collected through semi-structured face-to-face interviews with commissioners and care home providers. Providers are generally perceived by commissioners as highly altruistic, but also relatively financially motivated individuals. Further analysis revealed significantly different views towards profit-maximizing, which commissioners perceive as very important, while providers consider it to be of little motivational value. Private sector providers are described by commissioners as significantly more motivated by personal income. Associations are found between commissioners’ perceptions of motivations and the nature of their relationships with providers. Perceptions of providers’ motivations appear important within the commissioning framework.
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ABSTRACT: The cost of caring for people with intellectual disability currently makes up a large proportion of healthcare spending in western Europe, and may rise in line with the increasing numbers of people with intellectual disability now living to old age. To report service use and costs of older people with intellectual disability and explore the influence of sociodemographic and illness-related determinants. We collected data on receipt and costs of accommodation, health and personal care, physical as well as mental illness, dementia, sensory impairment and disability in a representative sample of adults with intellectual disability aged 60 years and older (n = 212). The average weekly cost in GBP per older person was 790 pounds (41,080 pounds per year). Accommodation accounted for 74%. Overall costs were highest for those living in congregate settings. Gender, intellectual disability severity, hearing impairment, physical disorder and mental illness had significant independent relationships with costs. Mental illness was associated with an additional weekly cost of 202 pounds. Older adults with intellectual disability comprise about 0.15-0.25% of the population of England but consume up to 5% of the total personal care budget. Interventions that meet needs and might prove to be cost-effective should be sought.The British journal of psychiatry: the journal of mental science 02/2010; 196(2):133-8. · 6.62 Impact Factor
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ABSTRACT: Awards and competitions are often used to motivate public servants, and this paper examines how the central government of China uses these to try and motivate cities to improve public hygiene. The authors argue that apart from improving performance,(1) awards and competitions are good at motivating user participation and spreading good practice. However, the design of the schemes used in China tends to prioritize disproportionately the winning mentality, and sometimes causes high costs and social tension.Environment and Urbanization 07/2013; · 1.67 Impact Factor