Consumer-Directed Community Care: Race/Ethnicity and Individual Differences in Preferences for Control

Sciegaj, Mark; Capitman, John A.; Kyriacou, Corrine Kay

doi:10.1093/geront/44.4.489

Cited by 31 publications

(28 citation statements)

References 13 publications

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“…There is some evidence that good support in the form of training and assistance with administrative and accounting tasks may increase older people's acceptance of and preparedness to enrol in a CDC programme (Sciegaj et al . , Foster et al . , Simon‐Rusinowitz et al .…”

Section: Introductionmentioning

confidence: 99%

Self-directed community services for older Australians: a stepped capacity-building approach

Ottmann

Mohebbi

2014

Health Soc Care Community

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Consumer-directed care (CDC) is increasingly widespread among aged care service options in Organisation for Economic Co-operation and Development (OECD) countries. However, the evidence base regarding the programmatic and contextual factors that affect the outcome of CDC interventions is surprisingly small. This paper reports on a self-directed care approach for older Australians with complex care needs. A multi-methods longitudinal comparative cohort study was employed comprising 4 survey tools and 56 semi-structured interviews. Participation rates were around 20%. A total of 185 (98 in the intervention and 87 in the control group) older people and carers were recruited at baseline. Eleven months later, 109 participants (59 in the intervention and 50 in the control group) completed the repeat measure. Attrition rates were around 40%. Data collection occurred between July 2010 and April 2012. The data suggest that intervention group participants were likely to be more satisfied with the way they were treated (P = 0.013), their care options (P = 0.014), the 'say' they had in their care (P < 0.001), the information they received regarding their care (P = 0.012), what they were achieving in life (P = 0.031), that the services changed their view on what could be achieved in life (P = 0.020) and with their standard of living (P = 0.008). The evaluation suggests that while only a very small segment of older people is interested in a voucher or cash option, a substantially larger group would like to have greater say over and more direct access to their care, without, however, assuming administrative and financial responsibilities. The paper concludes that a stepped capacity-building approach to CDC may improve the acceptability of CDC to older people and generate synergies that improve older people's care outcomes.

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Section: Introductionmentioning

confidence: 99%

Self-directed community services for older Australians: a stepped capacity-building approach

Ottmann

Mohebbi

2014

Health Soc Care Community

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“…This generalization, mirrored by an adaptive behavior of the older population, can explain the lower complaint and higher satisfaction rates of older persons within the health care system, even if there is no objective or rational justification for such behavior. This analysis is supported by the works of other scholars, for e.g., Sciegaj et al (2004), have argued that, traditionally, older people were not empowered to direct their own care, primarily because service providers and policy makers made assumptions about their level of interest and ability to exercise control.…”

Section: Older Persons and Complaints To Hmosmentioning

confidence: 65%

Unheard voices: complaint patterns of older persons in the health care system

et al. 2011

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To examine the patterns and prevalence of complaints about health services among older clients of Health Maintenance Organizations (HMOs), explore demographic correlates, and compare results with the patterns in the younger population. Primary data were collected from the responses of subjects who participated in two national phone surveys, conducted in Israel over a period of 2 years. The final sample included 372 participants aged 65 and older, and 796 younger persons, who believed they had reasons to complain about their HMO. Of the 372 participants with cause to complain, only 23% had actually complained. Subjects who were 75-years-old and above, with below-average income, had 2.5 times higher probability for not complaining than people under 65. No statistically significant differences were found between the older participants and younger participants regarding the reasons for complaints or the procedures for making them. Recommendations are made for the recognition of older persons as a unique group within the health care system and for developing organizational mechanisms for capturing their unheard voices by HMOs.

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“…Unsurprisingly, self-directed support is of particular interest to those who are dissatisfied with the services they are currently receiving, or who believe that their needs are only partially being met (Department of Health and Ageing 2012, Loughlin et al 2004, Mahoney et al 2002. Also, preferences vary among age groups in relation to the preferred model of support and the degree to which they would like control over their support (Adams & Drake 2006;Sciegaj et al 2004) or the support of the person they are caring for (Putnam et al 2010). Also, preferences vary among age groups in relation to the preferred model of support and the degree to which they would like control over their support (Adams & Drake 2006;Sciegaj et al 2004) or the support of the person they are caring for (Putnam et al 2010).…”

Section: Benefits Of Self-directed Supportmentioning

confidence: 99%

“…Research has demonstrated that consumers and caregivers vary in terms of their interest in managing the support received (Alakeson 2007;Duffy 2007a;Mahoney, Simon-Rusinowitz, Loughlin et al 2004;Olinzock 2004;Putnam et al 2010;Sciegaj et al 2004) and that over time, people may change their mind regarding the amount of control they desire (Putnam et al 2010; The State of Queensland 2012). Research has demonstrated that consumers and caregivers vary in terms of their interest in managing the support received (Alakeson 2007;Duffy 2007a;Mahoney, Simon-Rusinowitz, Loughlin et al 2004;Olinzock 2004;Putnam et al 2010;Sciegaj et al 2004) and that over time, people may change their mind regarding the amount of control they desire (Putnam et al 2010; The State of Queensland 2012).…”

Section: Challenges Of Self-directed Supportmentioning

confidence: 99%

The disability self‐direction movement: Considering the benefits and challenges for an Australian response

Crozier¹,

Muenchberger²,

Colley³

et al. 2013

Aust J Social Issues

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The following article provides a snapshot of the current self-direction movement within the disability sector across the industrialised world, with particular emphasis on the Australian context. As a global movement, self-direction has been in progress for several decades through a variety of implemented responses. Despite implementation variation, all self-direction models aim to facilitate individual control and decision making in care and support services. We describe self-direction, its various models and programs, and explore its benefits and challenges. We conclude by making broad recommendations for decision makers involved in self-direction. In particular, we offer a hierarchical decision tree that can be used to inform policy decisions at a systems -government policy -and organisational level.

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Consumer-Directed Community Care: Race/Ethnicity and Individual Differences in Preferences for Control

Abstract: Study findings suggest that consumer direction occurs along a continuum, with elders desiring control over some service areas but not others, and the importance of recognizing heterogeneity within racial/ethnic groups regarding consumer-directed care.

Cited by 31 publications

References 13 publications

Self-directed community services for older Australians: a stepped capacity-building approach

Self-directed community services for older Australians: a stepped capacity-building approach

Unheard voices: complaint patterns of older persons in the health care system

The disability self‐direction movement: Considering the benefits and challenges for an Australian response

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