Zhang Bo, Zhou Peng
School of Economics and Management, Beijing University of Chemical Technology, Beijing 100029, China.
Cardiff Business School, Cardiff University, Cardiff CF10 3EU, UK.
Healthcare (Basel). 2020 Sep 18;8(3):345. doi: 10.3390/healthcare8030345.
The ability to live independently plays a crucial role in the mental and psychological wellbeing of the disabled. To achieve this goal, most governments spend a substantial budget on home adaptation projects. It has been observed that schemes with different target clients (residents versus landlords) are different in efficiency and effectiveness. To understand why and how these schemes differ in performance, this paper develops and applies a generic economic evaluation framework for government-funded home adaptation schemes. Based on the individual-level surveys collected in the United Kingdom, an empirical model was formulated to quantify the determinants for various performance indicators, including money costs, time costs and client satisfaction. Robust estimation procedures were applied to deal with the heteroscedasticity and outlier problems in the data. Results showed that a specialized independent living scheme dedicated to disability adaptations (e.g., the Physical Adaptations Grant, PAG) had higher efficiency and effectiveness than general-purpose schemes (e.g., the Disabled Facilities Grant, DFG), because the funds were provided to the landlords who had a stronger motivation to minimize the time cost in the short run and maximize the future rent potential in the long run. A "unified system" approach to adaptations should be a guiding principle for policy development, regardless of who actually delivers the service.
独立生活能力对残疾人的精神和心理健康至关重要。为实现这一目标，大多数政府在家庭改造项目上投入了大量预算。据观察，针对不同目标客户（居民与房东）的计划在效率和效果上存在差异。为了解这些计划为何以及如何在绩效上有所不同，本文为政府资助的家庭改造计划开发并应用了一个通用的经济评估框架。基于在英国收集的个人层面调查数据，构建了一个实证模型来量化各种绩效指标的决定因素，包括资金成本、时间成本和客户满意度。应用稳健估计程序来处理数据中的异方差和异常值问题。结果表明，专门致力于残疾适应的独立生活计划（例如身体适应补助金，PAG）比通用计划（例如残疾设施补助金，DFG）具有更高的效率和效果，因为资金提供给了房东，他们在短期内有更强的动力将时间成本降至最低，在长期内有更强的动力使未来租金潜力最大化。无论实际提供服务的是谁，采用“统一系统”的改造方法都应成为政策制定的指导原则。
