John Hunter Hospital, Department of Neurology, New Lambton Heights, NSW 2305, Australia; and Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW 2305, Australia. Email:
Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW 2305, Australia. Email:
Aust Health Rev. 2021 Dec;45(6):745-752. doi: 10.1071/AH21056.
Objective This study is the first to assess if the National Disability Insurance Scheme (NDIS) package allocated to people with multiple sclerosis (pwMS) is correlated with the disability level measured by standardised neurological assessment. Methods We aimed to recruit 10 pwMS per expanded disability status score (EDSS) step, including EDSS 0 (no disability) up to 9 (bedridden), and requested information about their NDIS application. Value of their packages was compared with mobility, cognition and psychological impact. Results Out of 186 pwMS, only 49% of all patients had an NDIS package approved. The mean values of the annual allowance were AU$30 318 for patients with mild disability, AU$38 361 for moderate disability and AU$115 113 for severe disability. There was a striking variability in packages approved, but restricted mobility seems to be the driving factor. Rejection rates were <20% in patients with mild and moderate disability and none in those with severe disability. The package value correlated with EDSS steps, cognitive impairment and physical impact, but not psychological impact. Conclusions This is the first study to assess if NDIS packages correlate with internationally accepted disability scales. The NDIS support was correlated with disability measured by EDSS steps and cognition, but not psychological impact of the disease. What is known about the topic? There are over 25 000 Australians living with multiple sclerosis, which is one of the most common neurological diseases leading to disability in early age. The National Disability Insurance Scheme has been introduced since 2013 to particularly assist young disabled Australians to participate in the community. Whether the approved package correlates with internationally accepted disability scores has not yet been assessed. What does this paper add? This study is the first to correlate disability, as assessed by the Expanded Disability Severity Scale (EDSS), with the approved package value. What are the implications for practitioners? Multiple sclerosis is a very variable disease affecting quality of life not only due to impairment of mobility, but also cognition and mental health. Although the NDIS package value was correlated with an EDSS and cognition, the psychological impact of the disease is often neglected.
目的 本研究首次评估国家残疾保险计划（NDIS）分配给多发性硬化症（pwMS）患者的套餐是否与标准化神经评估测量的残疾程度相关。
方法 我们旨在招募每一个扩展残疾状态评分（EDSS）阶段的 10 名 pwMS，包括 EDSS 0（无残疾）至 9（卧床不起），并请求有关他们的 NDIS 申请的信息。套餐的价值与移动性、认知和心理影响进行了比较。
结果 在 186 名 pwMS 中，只有 49%的患者获得了 NDIS 套餐的批准。轻度残疾患者的年度津贴平均值为 30318 澳元，中度残疾患者为 38361 澳元，重度残疾患者为 115113 澳元。批准的套餐差异很大，但限制移动性似乎是驱动因素。轻度和中度残疾患者的拒绝率低于 20%，而重度残疾患者则没有。套餐价值与 EDSS 阶段、认知障碍和身体影响相关，但与疾病的心理影响无关。
结论 这是首次评估 NDIS 套餐是否与国际公认的残疾量表相关的研究。NDIS 的支持与 EDSS 步骤和认知测量的残疾相关，但与疾病的心理影响无关。
关于这个主题已经知道了什么？ 澳大利亚有超过 25000 人患有多发性硬化症，这是导致年轻人残疾的最常见的神经疾病之一。国家残疾保险计划自 2013 年以来推出，旨在特别帮助年轻残疾澳大利亚人参与社区活动。尚未评估批准的套餐是否与国际公认的残疾评分相关。
这篇论文增加了什么？ 本研究首次将扩展残疾严重程度评分（EDSS）评估的残疾与批准套餐价值相关联。
对从业者的影响是什么？ 多发性硬化症是一种非常多变的疾病，不仅会影响移动能力，还会影响认知和心理健康，从而影响生活质量。尽管 NDIS 套餐的价值与 EDSS 和认知相关，但疾病的心理影响往往被忽视。
