Marangos Anna Maria, Iedema Jurjen, de Klerk Mirjam, Woittiez Isolde, Groenewegen Peter P
The Netherlands Institute for Social Research, SCP, P.O. Box 16164, 2515 XP, The Hague, The Netherlands.
Nivel - Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN, Utrecht, The Netherlands.
J Patient Rep Outcomes. 2020 Nov 7;4(1):90. doi: 10.1186/s41687-020-00258-x.
Personal budgets for social and health care have been introduced in many European countries over recent decades. The assumption is that people with a personal budget are able to purchase care that matches their needs more closely and therefore experience greater independence and improved well-being. The question is whether this assumption is true. Little research has been carried out on this and the research that has been carried out is inconclusive and hampered by methodological limitations.
We performed a secondary analysis of data collected in a survey among persons who had submitted an application for social support. Propensity score matching was used to investigate whether people with a personal budget experience better independence, participation in society and quality of life than comparable people using conventionally organised help.
After matching, no significant effects of the personal budget were initially found. A sensitivity analysis that excluded the variable sense of mastery from the calculation of the propensity scores, showed a significantly greater independence for those using a personal budget.
There may be several reasons for this lack of effect. First, perhaps there are no effects. It is also possible that effects can only be found in specific situations and/or specific groups.
近几十年来，许多欧洲国家都引入了社会和医疗保健个人预算。其假设是，拥有个人预算的人能够购买更符合其需求的护理服务，从而体验到更大的独立性并改善幸福感。问题在于这一假设是否属实。对此开展的研究很少，且已开展的研究尚无定论，还受到方法学局限性的阻碍。
我们对一项针对申请社会支持者的调查所收集的数据进行了二次分析。倾向得分匹配法用于调查拥有个人预算的人相比使用传统组织帮助的类似人群，是否在独立性、社会参与度和生活质量方面表现更好。
匹配后，最初未发现个人预算有显著影响。一项在倾向得分计算中排除掌控感变量的敏感性分析显示，使用个人预算的人独立性显著更强。
缺乏效果可能有多种原因。首先，或许确实没有效果。也有可能只有在特定情况和/或特定群体中才能发现效果。
