Regulating Quality of Care in Nursing Homes in Hong Kong: A Social-Ecological Investigation

A social-ecological model aided by an adversarial methodology was employed to study the regulation of private nursing homes in Hong Kong over a five-year period. Specifically the study addresses the way quality of care and its definitions changed in response to shifting socio-political-economic conditions. The study began when only 2 percent of the industry was licensable. It was found that an initial period of harmful capture was replaced by a period of cooperation between government and the industry, following increased resource flow into the system that made it possible for desirable trade-offs to occur between the two parties. Six-and-a-half years after the introduction of the regulatory ordinance, all homes in the market achieved licensure status.