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采用案例研究方法来理解在国家残疾人保险计划下,为社区居住的后天性脑损伤个体提供个性化资助支持的途径。

A case study approach to understanding the pathway to individualised funded supports under the National Disability Insurance Scheme for community-dwelling individuals with acquired brain injury.

机构信息

Acquired Brain Injury Outreach Service (ABIOS), Division of Rehabilitation, Metro South Health, Brisbane, Australia.

Skills to Enable People and Communities Program (STEPS), Division of Rehabilitation, Metro South Health, Brisbane, Australia.

出版信息

Brain Impair. 2023 Dec;24(3):489-507. doi: 10.1017/BrImp.2022.21. Epub 2022 Sep 7.

DOI:10.1017/BrImp.2022.21
PMID:38167364
Abstract

BACKGROUND

The National Disability Insurance Scheme (NDIS) offers opportunity against a historical background of underfunded and fragmented services for people with disability. For people with acquired brain injury (ABI), concerns have been raised about how they access NDIS individualised funded supports. The aim of this research was to explore how community-dwelling individuals with ABI in Queensland navigate the NDIS participant pathway to individualised funded supports.

METHODS

This study used a multiple case study design within a policy implementation framework. Twelve people with ABI, nine family members and eight NDIS funded and mainstream service providers participated. Data was collected from relevant NDIS documentation, health records and semi-structured interviews with individuals with ABI, family members, and service providers.

RESULTS

The current study highlighted the complexity of navigating the NDIS participant pathway of access, planning, implementation and review for people with ABI, their family and service providers. The NDIS pathway was impacted by the insurance and market based NDIS model itself, time, communication, and the requirement for external supports. Equally, the process was affected by environmental factors, individual person and injury factors as well as service providers, with a range of outcomes evident at the individual, family and system level.

CONCLUSIONS

Findings suggest that the NDIS has struggled to make specific allowance for people with ABI and the complexity of their disabilities. Providing people with ABI access to the NDIS Complex Support Needs Pathway may redress many of the difficulties people with ABI experience accessing and using NDIS funded supports.

摘要

背景

国家残疾保险计划(NDIS)为残疾人提供了机会,这是在服务资金不足且分散的历史背景下实现的。对于获得性脑损伤(ABI)患者,人们担心他们如何获得 NDIS 的个性化资助支持。本研究旨在探讨昆士兰州的社区居住的 ABI 患者如何在 NDIS 参与者途径中获得个性化资助支持。

方法

本研究采用政策实施框架内的多案例研究设计。12 名 ABI 患者、9 名家庭成员和 8 名 NDIS 资助和主流服务提供者参与了研究。数据来自相关的 NDIS 文档、健康记录以及对 ABI 患者、家庭成员和服务提供者的半结构化访谈。

结果

本研究强调了 ABI 患者、其家人和服务提供者在获得、规划、实施和审查 NDIS 参与者途径方面的复杂性。NDIS 途径受到保险和基于市场的 NDIS 模式本身、时间、沟通以及对外来支持的需求的影响。同样,该过程受到环境因素、个人和伤害因素以及服务提供者的影响,在个人、家庭和系统层面都有一系列不同的结果。

结论

研究结果表明,NDIS 一直在努力为 ABI 患者及其残疾的复杂性做出具体的安排。为 ABI 患者提供 NDIS 复杂需求支持途径可能会解决许多 ABI 患者在获得和使用 NDIS 资助支持方面遇到的困难。

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