Background This paper provides important contextual and service implementation data by exploring participant experiences of a pilot case management intervention for long-term incapacity benefit (IB) ...recipients. Methods Service experiences were assessed via a postal questionnaire and semi-structured qualitative telephone interviews. Data from 77 service user questionnaires and 20 semi-structured qualitative interviews were obtained. Questionnaire data were analysed using SPSS and telephone interviews were transcribed, thematically coded and analysed using NVivo. Results Respondents were generally positive about their experience of the intervention and particularly the benefit gained from the personal support that case managers provided. However, they also made suggestions about how the service could be delivered more effectively particularly in terms of the duration of the treatments and increasing the level of face-to-face support. Conclusions Case management approaches may offer a supportive environment in which the health needs of those in the long-term receipt of IB can be addressed.
Abstract
This article describes the development and dissemination of an evidence-based Policy Statement and Background Papers by the Australian Rehabilitation and Assistive Technology Association ...(ARATA). An experienced project team was engaged to conduct literature reviews and member consultations, develop resources and implement a targeted advocacy strategy that included a policy launch and meetings with government officials. The Policy Statement and Background Papers have enabled ARATA to represent the views of Assistive Technology (AT) Practitioners in consultations around the National Disability Insurance Scheme and other AT-related inquiries. In ARATA's experience, developing a policy statement and disseminating it through a targeted advocacy strategy is an effective way for a not-for-profit professional organisation to influence government policy.Implications for RehabilitationAT practitioners must consider political factors in working towards effective policies to support their practice.To be effective at a systemic level, AT practitioners must develop political awareness and an understanding of the drivers of policy.This case study provides a blueprint for AT practitioners and organisations in tackling policy change.
Persons who are likely to be the heaviest users of medical and supportive care services--those with chronic illnesses, disabilities, and functional limitations--are often forced to navigate a system ...that requires them to perform most of the coordination functions themselves and is generally not organized around their needs. In 1996 an estimated 128 million Americans had at least one of these three conditions, and 9.5 million had all three. This paper examines the current programs designed to assist these persons and suggests changes in eligibility rules, coverage policies, and educational programs to provide a system more oriented to people's chronic care needs.
The targeting of an UK extra-cost disability benefit for older people, Attendance Allowance, is analyzed using longitudinal data from the British Household Panel Survey. First, a binary model of ...benefit participation is used to investigate whether receipt is responsive to the onset of disability. Second, matching estimators are used to evaluate the consequences of missed participation on later financial wellbeing. Results indicate that participation is highly responsive to the onset of disability, although the chance of delays in receipt emerges. Personal characteristics unrelated to eligibility also appear to influence benefit receipt, translating into sizeable differences in the amount of cash support received. The comparison of recipients with observationally equivalent non-recipients confirms that timely participation reduces disabled older people's financial strain.
Background Evidence suggests that overall the benefits of work are greater than the harmful effects of long-term unemployment and prolonged sickness absence. General practitioners (GPs) often feel ...that work and health-related issues extend beyond their role. There is a paucity of research that focuses on GPs’ attitudes to the management of long-term worklessness. Aims To explore GPs’ perceptions of the management of individuals in receipt of long-term incapacity benefits and their attitudes to UK government funded return to work programmes such as the Want2Work scheme in Wales. Methods A qualitative study set in South Wales. Focus groups were conducted with GPs and explored the role of primary care and the challenges that GPs face when managing long-term worklessness and how the Want2Work programme might benefit GP practice. Data were analysed using the framework method of analysis. Results The main themes that emerged from the GP focus groups were role boundaries, responsibilities, negotiation and knowledge. A key finding was that many of the participants felt that their role in managing long-term worklessness was limited to providing support and management of health-related issues only. The perceived risk to their own personal safety in addressing these issues with some patients also impacted on GPs’ decision making Conclusions There seems to be a clear divide between managing patients’ health concerns and their work-related activities. Some GPs recognized that patients became ‘lost’ in their system once receiving long-term benefits.
We analyzed programs managed by the ten biggest social health insurance companies in Germany that aim at early detection, prevention, and promotion of health in depression.
We conducted interviews ...with the responsible managers and studied relevant web sites.
The content of these programs ranges from internet-based offers to relaxation techniques. There is very little information publicly available on the results of these programs; the same holds true for the number of participants, efficiency, and cooperation with physicians.
There is a strong need to investigate results and efficiency of the programs.
This article describes experiences in implementing a community mental health and development project in a rural district in southern India, including the position of persons with mental illness when ...the project was initiated, the challenges the faced and the strategies that were developed to overcome these challenges. The authors conclude that when services are locally available, persons with mental illness can be treated and rehabilitated within their own community. They can live with dignity and their rights are respected. There is a great need for inclusion of persons with mental illness in the existing developmental activities and in disabled persons’ organizations.doi 10.5463/DCID.v22i2.58
OBJECTIVES: This randomized clinical trial assessed whether a community-based representative payee program that was coordinated with psychiatric care from the Department of Veterans Affairs was more ...effective than customary treatment. METHODS: In the experimental condition representative payeeship was provided by a community agency that worked to enroll clients and coordinate payeeship with clinical care through communication with clinical staff. The control condition consisted of customary clinical care that included the typical availability of representative payeeship. Hypotheses were that, compared with the control group, the experimental group would experience greater enrollment in a representative payee program; improved residential status; improved quality of life, including fewer symptoms of mental illness; less substance abuse; and improved money management. Participants were interviewed at baseline and at six and 12 months. Outcomes were analyzed with analysis of covariance by using covariates from the baseline. RESULTS: A total of 184 participants were enrolled at baseline (94 in the experimental group and 90 in the control group). A total of 152 interviews were completed at six months, and 149 were completed at 12 months. At 12 months, 31 percent of patients in the experimental group and 14 percent of those in the control group were receiving representative payee services. At 12 months, significant positive effects were observed for the experimental group on enrollment in a representative payeeship, alcohol and drug use, quality of life, and money management. Residential status approached significance. CONCLUSIONS: Use of a coordinated representative payee program was found to be effective in improving outcomes at 12 months. Although this evidence supports the wider implementation of a coordinated representative payee program, only 31 percent of the experimental group had their money banked with a representative payee. Therefore, future studies should focus on achieving a better understanding of the causal components of the intervention.
In contrast to the considerable body of literature concerning the disabilities of the general population, little information exists pertaining to the disabilities of the farm population. Focusing on ...the disability issue to the insurants in the Farmers' Health Insurance (FHI) program in Taiwan, this paper examines the associations among socio-demographic characteristics, insured factors, and the introduction of the national health insurance program, as well as the types and payments of disabilities among the insurants.
A unique dataset containing 1,594,439 insurants in 2008 was used in this research. A logistic regression model was estimated for the likelihood of received disability payments. By focusing on the recipients, a disability payment and a disability type equation were estimated using the ordinary least squares method and a multinomial logistic model, respectively, to investigate the effects of the exogenous factors on their received payments and the likelihood of having different types of disabilities.
Age and different job categories are significantly associated with the likelihood of receiving disability payments. Compared to those under age 45, the likelihood is higher among recipients aged 85 and above (the odds ratio is 8.04). Compared to hired workers, the odds ratios for self-employed and spouses of farm operators who were not members of farmers' associations are 0.97 and 0.85, respectively. In addition, older insurants are more likely to have eye problems; few differences in disability types are related to insured job categories.
Results indicate that older farmers are more likely to receive disability payments, but the likelihood is not much different among insurants of various job categories. Among all of the selected types of disability, a highest likelihood is found for eye disability. In addition, the introduction of the national health insurance program decreases the likelihood of receiving disability payments. The experience in Taiwan can be valuable for other countries that are in an initial stage to implement a universal health insurance program.
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