Moving Beyond Regulation: Cross‐Sectoral Coordination in Providing Holistic Care in For‐Profit Residential Homes for Disabled People

Abstract

ABSTRACTThe recent decades have seen an increasing trend in market‐oriented reforms in long‐term care, yet concerns about the quality of care persist, especially with for‐profit providers. Recently, Hong Kong has pioneered a shift from reinforcing government regulation to a collaborative model that leverages the capabilities of the nonprofit sector to support for‐profit providers. A key aspect of this approach is the coordination involving different sectors, which remains a less explored domain in health and social care literature. Through interviews and focus groups with stakeholders, including nonprofit operators, for‐profit providers, service users, and their carers, this study explored the coordinated work process in this newly initiated project. Analysis of participant accounts highlights the importance of relational coordination to the approach, as effective coordination among stakeholders in this context greatly depended on the quality of stakeholder relationships. This coordination was characterized by shared goals, shared knowledge, and timely, problem‐solving, and supportive communication. The dedicated efforts of nonprofit operators supported relational coordination by acting as a ‘boundary spanner’ that liaised with major stakeholders, and serving as a change agent which seized every opportunity to enhance the quality of coordination in the original system. The paper showcases a successful approach that utilizes cross‐sectoral coordination to enhance service quality in the private sector and reveals various strategies and concerns in engaging for‐profit operators, demonstrating a promising way for closer collaboration between the two sectors to mitigate the mixed effects of the marketization of long‐term care.