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Health Soc Care Community ; 13(1): 56-63, 2005 Jan.
Article in English | MEDLINE | ID: mdl-15717907

ABSTRACT

A qualitative study involving semi-structured interviews with 31 people with disabilities and 32 carers in the state of Queensland, Australia, found that their experience of supportive service delivery had not improved despite reforms of the service delivery system driven by a version of the quasi-market model. Instead of delivering increased consumer choice and improved efficiency in service delivery, service users experienced inadequate service supply, service cutbacks, and an increased emphasis on cost subsidisation and assessment processes. Additionally, few consumers felt that individualised funding arrangements had personally delivered the benefits which the quasi-market model and associated policy paradigm had indicated that they should receive. For many consumers, the notion of consumer 'choice' around service provision was fictitious and they felt that any efficiency gains were at the agency level, largely at the consumers' cost. It is concluded that there appears to be no particular benefit to service users of quasi-market reforms, particularly in policy contexts where service delivery systems are historically under-funded.


Subject(s)
Community Health Services/standards , Contract Services/standards , Disabled Persons , Personal Health Services/standards , Social Support , Community Health Services/economics , Community Health Services/organization & administration , Decision Making, Organizational , Health Care Reform , Humans , Interviews as Topic , Personal Health Services/economics , Personal Health Services/organization & administration , Quality of Health Care , Queensland , Rural Health Services/standards , Social Welfare , Urban Health Services/standards
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