Malbon Eleanor, Weier Megan, Carey Gemma, Writer Thomas
Centre for Social Impact, University of New South Wales, Sydney, NSW, 2052, Australia.
BMC Public Health. 2022 May 3;22(1):878. doi: 10.1186/s12889-022-13301-x.
Researchers and policymakers are increasingly concerned that personalisation schemes in social and health care might be worsening social and health inequities. This has been found internationally, where better outcomes from such schemes have been found amongst those who have higher education and more household income.
This study looks at one of the world's largest personalisation schemes, the Australian National Disability Insurance Scheme. Using publicly available data we examine the allocation and utilisation of NDIS funds according to social gradient.
We find that the rate at which people with disability 'spend' or effectively use their disability care funds follows a social gradient. That is, those in areas of higher socioeconomic disadvantage are not spending as much of their allocated budgets on care services across the year compared to people in areas of higher socioeconomic advantage. This represents a clear issue of equity in the use of public money to people with disability in Australia.
We argue that this points to the need to provide targeted supports for the use of disability care funds in areas of higher socioeconomic disadvantage. Without effective supports for fund use, the NDIS and other personalisation schemes may be positioned to worsen existing social inequalities.
研究人员和政策制定者越来越担心，社会和医疗保健领域的个性化方案可能会加剧社会和健康不平等。这在国际上已被发现，在那些接受过高等教育且家庭收入较高的人群中，此类方案取得了更好的效果。
本研究考察了世界上最大的个性化方案之一，即澳大利亚国家残疾保险计划。我们利用公开可得的数据，根据社会梯度来研究该计划资金的分配和使用情况。
我们发现，残疾人士“花费”或有效使用其残疾护理资金的比例呈现出社会梯度。也就是说，与社会经济优势较高地区的人相比，社会经济劣势较高地区的人在全年用于护理服务的预算分配中支出较少。这在澳大利亚使用公共资金为残疾人士提供服务方面，明显体现了公平问题。
我们认为，这表明有必要为社会经济劣势较高地区的残疾护理资金使用提供有针对性的支持。如果没有对资金使用的有效支持，国家残疾保险计划和其他个性化方案可能会加剧现有的社会不平等。
