Rehabilitation services in the health sector: the perspectives of providers and consumers: Part 1.
OBJECTIVE
To establish the degree of implementation of the Strategic Planning Guidelines for Area Health Boards--Services for Adults with Physical Disability, published by the Department of Health in 1989, the services being provided, and the priorities for future service provision.


METHODS
Two postal surveys of area health boards (AHB's) were carried out in 1991. The first asked about the terminology of rehabilitation, administrative structure, advocacy, service audit, inventory of services, regional service delivery, and consultation processes. The second asked about the rehabilitation services provided, the type of disability of the consumers of the service, the reasons why services were or were not provided, the service gaps that existed, and the priorities that existed to fill those service gaps.


RESULTS
The major finding was that while all area health boards adopted the rehabilitation concepts in principle, service development was impeded in many cases by the failure to provide resources to plan and develop the service. Some were providing comprehensive services. Most AHB's provided services for people with physical or multiple disabilities. All provided statutory services such as district nursing and home help, while most provided regular medical reviews, physiotherapy, occupational therapy, speech therapy, etc. Only about half provided attendant care, driving assessment, and swimming for people with disabilities, while less than half supported disability information services (DIS). Attendant care was seen as high priority to fill gaps in service, but was seen as the funding responsibility of the Department of Social Welfare.


CONCLUSIONS
Service provision reflected a traditional approach to the provision of rehabilitation services. The development of innovative service delivery will require crown health enterprises to reevaluate their present level of commitment to rehabilitation services and to assess the effectiveness of reallocating some funds from acute services into rehabilitation.
Caradoc-Davies
T
T
Department of Medicine, University of Otago Medical School, Dunedin.
Hawker
A
A
D017408:Guidelines as Topic; D006284:Health Plan Implementation; D006302:Health Services Research; D006801:Humans; D009520:New Zealand; D012040:Regional Health Planning / Q000458:organization & administration*; D012047:Rehabilitation Centers / Q000458:organization & administration*