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      Lessons for regulating informal markets and implications for quality assurance – the case of migrant care workers in Austria

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          ABSTRACT

          The rising number of private care arrangements in which live-in migrant care workers are engaged as a functional equivalent to family care calls for special attention by policy makers and formal long-term care providers on their implications for quality assurance and professional standards in the long-term care sector. Austria is one of the first countries in Europe where tangible legal measures have been taken to regulate this area under the heading of ‘24-hour care’, typically provided by middle-aged women. Reform measures went beyond policing and control mechanisms, including also incentives and tangible subsidies for all stakeholders. This paper contributes to a better understanding of their impact on the transition from informal to formal economy, focusing on quality assurance and working conditions. Based on empirical data and findings from semi-structured interviews with relevant stakeholders, a framework for the analysis of ‘illegal markets', based on Beckert and Wehinger's theory, is used to discuss potential implications in terms of valuation, competition and co-operation for policy in Austria, and to draw lessons for other countries. Results indicate that even after efforts to ‘legalise’ migrant care, the sector remains a ‘grey’ area within modern labour market legislation and quality management. This is due to the very nature of personal care, low professional status associated with care work and the reluctance of political stakeholders to regulate private household activities.

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          What is nursing home quality and how is it measured?

          In this commentary, we examine nursing home quality and indicators that have been used to measure nursing home quality. A brief review of the history of nursing home quality is presented that provides some context and insight into currently used quality indicators. Donabedian's structure, process, and outcome (SPO) model is used to frame the discussion. Current quality indicators and quality initiatives are discussed, including those included in the Facility Quality Indicator Profile Report, Nursing Home Compare, deficiency citations included as part of Medicare/Medicaid certification, and the Advancing Excellence Campaign. Current quality indicators are presented as a mix of structural, process, and outcome measures, each of which has noted advantages and disadvantages. We speculate on steps that need to be taken in the future to address and potentially improve the quality of care provided by nursing homes, including report cards, pay for performance, market-based incentives, and policy developments in the certification process. Areas for future research are identified throughout the review. We conclude that improvements in nursing home quality have likely occurred, but improvements are still needed.
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            In the shadow: illegal markets and economic sociology

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              Whose empowerment and independence? A cross-national perspective on ‘cash for care’ schemes

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                Author and article information

                Journal
                applab
                Ageing and Society
                Ageing and Society
                Cambridge University Press (CUP)
                0144-686X
                1469-1779
                April 2016
                February 4 2015
                April 2016
                : 36
                : 04
                : 741-763
                Article
                10.1017/S0144686X1500001X
                891ab0c1-bfde-4e74-b532-bc6283dbf857
                © 2016
                History

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