Does type of provider matter for staff well-being? a cross-sectional study of residential care home workers' job demands and resources.

Abstract

Background: Marketisation trends have introduced new elements in residential care homes, potentially related to the psychosocial work environment and well-being of care workers. Objective: This study examined differences in job demands and resources across public, outsourced, and private residential care home providers and their associations with care workers' burnout, job satisfaction, and turnover intentions. Methods: Data from 253 care workers across 19 residential care homes in three municipalities were analysed using a cross-sectional design, with a 45.3% response rate. We applied the Job Demands-Resources theory and the Copenhagen psychosocial questionnaire, conducting analyses of variance and multiple regressions with Generalised Estimating Equations to account for nested data. Results: Outsourced care workers reported higher emotional demands than those in the public sector, while private providers offered greater influence and supervisor support compared to public ones. Burnout levels were significantly higher in the medium-sized municipality compared to the small one, while provider type was not significant. Private care workers reported higher job satisfaction, but public sector workers reported better work-life balance. Approximately 60% of respondents considered leaving their jobs at least occasionally, with public sector workers reporting higher turnover intentions than those in for-profit settings. Conclusions: The study highlights the need for targeted work environment improvements, including better leadership and support in the public sector, addressing emotional demands in outsourced settings, and encouraging full-time employment to support work-life balance in the private sector. Stakeholders should prioritise improving job resources to improve care workers' well-being, especially amid budget constraints and profit goals.