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公共资金,私人服务:澳大利亚独立言语治疗师对公共资金资助模式的看法。

Public purse, private service: The perceptions of public funding models of Australian independent speech-language pathologists.

机构信息

Department of Audiology & Speech Pathology, The University of Melbourne, Melbourne, Australia.

Word By Mouth Speech Pathology, Melbourne, Australia.

出版信息

Int J Speech Lang Pathol. 2023 Jun;25(3):462-478. doi: 10.1080/17549507.2023.2213864. Epub 2023 Jun 5.

Abstract

PURPOSE

Health funding provisions supported by governments are pivotal for families accessing independent speech-language pathology services in Australia. Little is known of the facilitators and barriers that exist for accessing public funding for speech-language pathology services through independent providers. This study aimed to investigate and describe the perceptions of speech-language pathologists in accessing public funding models (PFMs) for children and young persons with communication and swallowing needs within Australian independent practice.

METHOD

Semi-structured qualitative interviews were conducted with twenty independent speech-language pathologists who had experience of PFMs in Australia. Digitally recorded interviews were transcribed verbatim and subjected to thematic analysis.

RESULT

Data analysis revealed five superordinate and eighteen subordinate themes. The five superordinate themes were: (a) accessibility in securing funding provisions; (b) time as a commodity; (c) incongruence between funding provisions and speech-language pathology evidence; (d) trust as a multifaceted quality; and (e) consequences of PFMs.

CONCLUSION

This original and timely research offers perceptive descriptions of the multifaceted facilitators and barriers for families seeking to access public funding for independent speech-language pathology services in Australia. Research findings illuminate challenges for the speech-language pathology profession. Accessibility to funding was identified as a major issue. Research findings suggest that current funding provisions do not align with the dosage required for evidence-based speech-language pathology management. Further, this research has highlighted the need for funding to be equitable, acceptable to stakeholders, and for services to be delivered in an efficient and sustainable manner. Future research is recommended to understand which Australian PFMs: (a) facilitate consumer access to speech-language pathology services; (b) enrich consumer experiences; and (c) align with scientific evidence to promote optimal outcomes.

摘要

目的

政府支持的健康资金规定对于澳大利亚家庭获得独立的言语治疗服务至关重要。对于通过独立提供者获得言语治疗服务公共资金的促进因素和障碍,知之甚少。本研究旨在调查和描述澳大利亚独立实践中言语治疗师对儿童和年轻人的沟通和吞咽需求的公共资金模式(PFMs)的看法。

方法

对 20 名具有澳大利亚 PFMs 经验的独立言语治疗师进行了半结构化定性访谈。对数字记录的访谈进行了逐字转录,并进行了主题分析。

结果

数据分析揭示了五个上位主题和十八个下位主题。五个上位主题是:(a)获取资金规定的可及性;(b)时间作为商品;(c)资金规定与言语治疗证据之间的不匹配;(d)信任是多方面的品质;以及(e)PFMs 的后果。

结论

这项原创且及时的研究提供了对澳大利亚家庭寻求获得独立言语治疗服务公共资金的多方面促进因素和障碍的敏感描述。研究结果为言语治疗专业带来了挑战。资金获取被确定为一个主要问题。研究结果表明,目前的资金规定与循证言语治疗管理所需的剂量不匹配。此外,这项研究强调需要公平的资金、利益相关者可接受的资金,以及以高效和可持续的方式提供服务。建议进行未来研究,以了解哪些澳大利亚 PFMs:(a)促进消费者获得言语治疗服务;(b)丰富消费者体验;以及(c)与科学证据保持一致,以促进最佳结果。

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