Luxembourg Institute of Socio-Economic Research (LISER), 4366 Esch-sur-Alzette, Luxembourg.
Faculty of Psychology, University of Vienna, 1010 Vienna, Austria.
Int J Environ Res Public Health. 2022 Dec 4;19(23):16225. doi: 10.3390/ijerph192316225.
This article reviews the peer-reviewed and grey literature published from January 1985 to November 2022 that has quantitatively evaluated the effects of personalized budgets for people with disabilities (PwDs), in terms of a range of benefit and cost outcomes. Benefit metrics of interest comprised measures of well-being, service satisfaction and use, quality of life, health, and unmet needs. A search was conducted using the PsycINFO, MEDLINE, CINAHL, ASSIA, and Social Care Online databases. Based on inclusion criteria and a quality assessment using the Downs and Black Checklist, a final count of 23 studies were identified for in-depth review. Given the heterogeneous nature of the studies, a narrative synthesis, rather than a formal meta-analysis, was undertaken. Taking the relatively scarce and often methodologically limited evidence base at face value, the findings suggest that-overall-personalized budget users tend to benefit in terms of well-being and service satisfaction outcomes, with the exception of mixed effects for people with mental health conditions. Only a minority of studies have investigated the cost-effectiveness or costs-only of personalized budgets, finding mixed results. Two out of the three cost-effectiveness studies find personal budgets to be more cost-effective than alternative options, meaning that the possibly higher costs of personalized budgets may be more than outweighed by additional benefits. Some evidence looking at service use and/or costs only also points to significant reductions in certain service use areas, which at least hints at the potential that personalized budgeting may-in some cases-entail reduced costs. Further research is needed to explore the generalizability of these conclusions and to better capture and understand the factors driving the observed heterogeneity in some of the results.
本文回顾了 1985 年 1 月至 2022 年 11 月期间发表的同行评议和灰色文献，这些文献定量评估了个人预算对残疾人（PwDs）的影响，涉及一系列效益和成本结果。感兴趣的效益指标包括幸福感、服务满意度和使用情况、生活质量、健康和未满足的需求。使用 PsycINFO、MEDLINE、CINAHL、ASSIA 和 Social Care Online 数据库进行了搜索。根据纳入标准和使用 Downs 和 Black 清单进行的质量评估，最终确定了 23 项研究进行深入审查。鉴于研究的异质性，进行了叙述性综合分析，而不是正式的荟萃分析。考虑到研究证据相对稀缺且往往方法有限，研究结果表明——总体而言——个人预算使用者在幸福感和服务满意度方面往往受益，心理健康状况者除外，其结果存在混合影响。只有少数研究调查了个人预算的成本效益或仅成本，结果喜忧参半。三项成本效益研究中有两项发现个人预算比替代方案更具成本效益，这意味着个人预算可能更高的成本可能会被额外的效益所抵消。仅关注服务使用和/或成本的一些证据也表明某些服务使用领域的显著减少，这至少暗示了个性化预算在某些情况下可能会降低成本的可能性。需要进一步研究来探索这些结论的普遍性，并更好地捕捉和理解导致某些结果存在异质性的因素。
