How Do the Market Shares of For-Profit and New Home Care Services Affect the Quality of Long-Term Care for Older Adults? Insights from the Korean Experience.

As the long-term care needs of older adults have increased, the marketization of care providers has become a commonly adopted policy in many countries; however, empirical research on its impact on service quality remains scarce. This study examines how the market shares of for-profit entities and new agencies affect the quality of long-term care in Korea. Administrative data from the Korean National Health Insurance Service and the Korean National Statistical Office were analyzed across 245 districts. Data were merged in 2016-2017 for service quality evaluation, and multiple imputation analysis was conducted to address observation variations and missing values. Findings indicate that higher market shares of for-profit providers and newly opened agencies are associated with lower service quality. Governments and local authorities should strengthen quality assurance in-home care by overseeing for-profit providers, seeking an optimal level of market shares among different care provider entities, and regulating the entry of newly established agencies into the already saturated care services market.