Do non-profit operators provide higher quality of care? Evidence from micro-level data for Japan's long-term care industry

Haruko Noguchi, Satoshi Shimizutani

Research output: Contribution to journalArticle

2 Citations (Scopus)


Along with the introduction of the long-term care insurance scheme, the Japanese government in 2000 for the first time allowed for-profit operators to compete head-on with non-profit operators in the provision of at-home care services. This study examines quality differentials between the non-profit and the for-profit sector in Japan's elderly care industry, concentrating on home helpers and staff nurses. Taking advantage of a unique and rich micro-level survey, the study finds that although non-profit operators provide higher quality of care, as measured by simple averages of workers' characteristics, the advantage of non-profits disappears once their higher wage is corrected for. This finding confirms that the seemingly higher quality of care provided by non-profit operators is due to the non-profit wage premium, resulting from their preferential status which provides non-distributional constraints and favorable tax treatment.

Original languageEnglish
Pages (from-to)125-135
Number of pages11
JournalHitotsubashi Journal of Economics
Issue number1
Publication statusPublished - 2006 Jun 1



  • Long-term care
  • Non-profit wage premium
  • Nursing homes
  • Quality of care
  • Treatment effect approach

ASJC Scopus subject areas

  • Business, Management and Accounting(all)
  • Economics and Econometrics

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