Individualized funding interventions to improve health and social care outcomes for people with a disability: A mixed‐methods systematic review

Fleming, Pádraic; McGilloway, Sinéad; Hernon, Marian; Furlong, Mairéad; O'Doherty, Siobhain; Keogh, Fiona; Stainton, Tim

doi:10.4073/csr.2019.3

Cited by 49 publications

(46 citation statements)

References 231 publications

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“…Organizations will be forced to either withdraw from the scheme due to financial pressures or abandon the additional, unfunded work that may place more burden on remaining providers, or on families who are left with nowhere to turn if this administrative burden is not picked up by government or advocacy organizations. It is worth noting that growth in administrative burdens has been a feature of personalization schemes internationally (Fleming et al, 2019). Generally, these have been attributed to the design of overly complex systems that have emerged naturally out of poor design and could therefore be corrected through redesign (Fleming et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…It is worth noting that growth in administrative burdens has been a feature of personalization schemes internationally (Fleming et al, 2019). Generally, these have been attributed to the design of overly complex systems that have emerged naturally out of poor design and could therefore be corrected through redesign (Fleming et al, 2019). However, there may be deeper drivers worth investigating.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, under block funding arrangements, any surplus generated would typically be returned to government, so unless the organization had other income streams it would not accumulate surpluses to support major investments in the types of systems and processes required of individualized funding. Moreover, personalization schemes have been characterized by administrative complexity, which is challenging for providers and users alike (Fleming et al, 2019). While launching later than its international counterparts, the Australian NDIS and providers operating within it have been met with similar challenges.…”

Section: Disability Policy and The Personalization Trendmentioning

confidence: 99%

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Burdensome Administration and Its Risks: Competing Logics in Policy Implementation

Carey¹,

Dickinson²,

Malbon

et al. 2020

Administration & Society

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Australia is currently undergoing significant social policy reform under the introduction of a personalized scheme for disability services: the National Disability Insurance Scheme (NDIS). This article explores the growing administrative burdens placed on disability providers operating under the new scheme, using an Australia-wide survey of the disability sector. The 2018 National Disability Services survey of the disability sector reveals that administrative burden is the most commented on challenge for providers. Moreover, providers linked this burden to questions concerning their financial sustainability and ability to continue to offer services within the NDIS. In this article, we explore the sources of these administrative burdens and their relationships with the institutional logics at play in the NDIS. In addition to documenting the impact of system change on the Australian disability service sector, this article raises questions regarding institutional hybridity within personalization schemes more broadly and whether they are a source of tension, innovation, or both.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Disability Policy and The Personalization Trendmentioning

confidence: 99%

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Burdensome Administration and Its Risks: Competing Logics in Policy Implementation

Carey¹,

Dickinson²,

Malbon

et al. 2020

Administration & Society

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“…Whereas many service users may have been deterred by the relative unattractiveness of previous systems, improved choice and direction in decision-making may increase demand. A systematic review of research on the effectiveness of individualised funding schemes across several countries has found that fears in relation to the overwhelming of the social care system's capacity due to an introduction of individualised funding are not supported by evidence (Fleming et al, 2019). However, it has been pointed out that, as demand for social protection begins to exceed budgetary limitations, governments face an inevitable trade-off between the coverage and the generosity of the support system.…”

Section: Development Of Individualised Funding Schemesmentioning

confidence: 99%

Specialist support for persons with disabilities living in the community: Review of international practice

Domhnaill¹,

Lyons²,

McCoy³

2020

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The mission of the Economic and Social Research Institute is to advance evidencebased policymaking that supports economic sustainability and social progress in Ireland. ESRI researchers apply the highest standards of academic excellence to challenges facing policymakers, focusing on 12 areas of critical importance to 21st Century Ireland. The Institute was founded in 1960 by a group of senior civil servants led by Dr T. K. Whitaker, who identified the need for independent and in-depth research analysis to provide a robust evidence base for policymaking in Ireland. Since then, the Institute has remained committed to independent research and its work is free of any expressed ideology or political position. The Institute publishes all research reaching the appropriate academic standard, irrespective of its findings or who funds the research. The quality of its research output is guaranteed by a rigorous peer review process. ESRI researchers are experts in their fields and are committed to producing work that meets the highest academic standards and practices. The work of the Institute is disseminated widely in books, journal articles and reports. ESRI publications are available to download, free of charge, from its website. Additionally, ESRI staff communicate research findings at regular conferences and seminars. The ESRI is a company limited by guarantee, answerable to its members and governed by a Council, comprising 14 members who represent a cross-section of ESRI members from academia, civil services, state agencies, businesses and civil society. The Institute receives an annual grant-in-aid from the Department of Public Expenditure and Reform to support the scientific and public interest elements of the Institute's activities; the grant accounted for an average of 30 per cent of the Institute's income over the lifetime of the last Research Strategy. The remaining funding comes from research programmes supported by government departments and agencies, public bodies and competitive research programmes.

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“…Recently, an international shift from traditional, group-disability supports toward individualised funding has occurred (Fleming et al 2019). In Australia, a government funded individual disability package known as the National Disability Insurance Scheme (NDIS) was progressively implemented from 2016.…”

Section: Introductionmentioning

confidence: 99%

Goal Attainment and Outcomes of Physiotherapy Participants Funded by an Individualised Government Package’

Bravo

McCredie²,

Scrivener

2020

Preprint

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Purpose: To determine goal attainment and change in physical outcomes of individuals participating in a community Physiotherapy program funded by a new government funding package, the National Disability Insurance Scheme (NDIS). Additionally, to describe the alignment of NDIS goals with Physiotherapy goals and the impact of the NDIS on access to Physiotherapy.Methods: A consecutive case series was conducted involving 12 participants attending NDIS-funded Physiotherapy at a private clinic in Sydney, Australia. Outcome measures were recorded upon entry to the study and again after 6 months or at discharge, whichever occurred first. The primary outcome was goal attainment measured by the Goal Attainment Scale. Secondary outcomes included the 5-metre walk test, Motor Assessment Scale, World Health Organisation Quality of Life questionnaire and Exercise Self Efficacy Scale.Results: Forty-one percent of goals were fully attained and for 53% performance was equal to baseline, however, this was not reflected in concurrently measured outcomes where small changes occurred. Physiotherapy goals focused on mobility whilst NDIS goals varied. Changes in outcome measures differed between individuals. NDIS funding provided all participants access to more frequent or otherwise inaccessible Physiotherapy.Conclusion: Physiotherapy participants funded by an individualised government package had improved access to Physiotherapy where participants attained individualised goals.

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Individualized funding interventions to improve health and social care outcomes for people with a disability: A mixed‐methods systematic review

Cited by 49 publications

References 231 publications

Burdensome Administration and Its Risks: Competing Logics in Policy Implementation

Burdensome Administration and Its Risks: Competing Logics in Policy Implementation

Specialist support for persons with disabilities living in the community: Review of international practice

Goal Attainment and Outcomes of Physiotherapy Participants Funded by an Individualised Government Package’

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