Glendinning Caroline, Halliwell Shirley, Jacobs Sally, Rummery Kerstein, Tyrer Jane
National Primary Care Research and Development Centre,Health Service Management Unit, University of Manchester.
Health Soc Care Community. 2000 May;8(3):192-200. doi: 10.1046/j.1365-2524.2000.00244.x.
This paper reports on a study of disabled people with receiving Direct Payments who were able to purchase assistance in ways that cross conventional boundaries between 'health' and 'social' services. Indeed, most of the Direct Payment recipients used the term 'personal care' to describe a range of help that extended right across this conventional divide. Nevertheless, most of the users reported purchasing help with aspects of health care through their Direct Payments, including physiotherapy, management of incontinence, chiropody, changing dressings and sustaining tissue viability. They chose to purchase this help from their personal assistants (PAs) because statutory services were not available, had been withdrawn, or because they were able to retain greater independence and control over their lives compared with receiving conventional services. Many Direct Payment users wanted more opportunities to purchase a range of health-related services, although this also raised questions about training, supervision and the professionalisation of flexible personal assistance. The paper concludes that health purchasers may need to consider contributing to Direct Payments in acknowledgement of the health care which such schemes are currently providing.
本文报道了一项针对领取直接付款的残疾人的研究，这些残疾人能够以跨越“健康”和“社会”服务之间传统界限的方式购买援助。事实上，大多数直接付款接受者使用“个人护理”一词来描述一系列跨越这一传统划分的帮助。然而，大多数用户报告称通过直接付款购买了医疗保健方面的帮助，包括物理治疗、大小便失禁管理、足疗、换药以及维持组织活力。他们选择从个人助理那里购买这种帮助，原因是法定服务不可用、已被撤回，或者与接受传统服务相比，他们能够在生活中保持更大的独立性和控制权。许多直接付款用户希望有更多机会购买一系列与健康相关的服务，尽管这也引发了关于培训、监督以及灵活个人援助专业化的问题。本文得出结论，医疗保健购买者可能需要考虑为直接付款做出贡献，以认可此类计划目前正在提供的医疗保健服务。
