Rehabilitation services in the health sector: the perspectives of providers and consumers: Part 2.
OBJECTIVE
To gain information from consumers of rehabilitation services about service use and availability, and priorities for future development. To compare this with area health board (AHB) priorities for future services.


METHODS
A postal survey of 740 consumers of rehabilitation services used the membership list of the Disabled Persons' Assembly (DPA) of New Zealand. There was a 311 (42%) response rate of whom 84% were people with disabilities and 16% were care givers.


RESULTS
Causes of disability included illness (45%), congenital (26%), accidents (22%), and multiple causes (7%). Most people had physical (66%) or multiple disabilities (22%), while few had sensory (7%), intellectual (3%), psychiatric (3%), or learning disabilities (0.4%). The main factors affecting service delivery were lack of information, restricted service, needs not assessed, difficult access to services, lack of coordination, and transport difficulties. Most respondents were aware of statutory services such as district nursing, home help, occupational therapy, physiotherapy, social work and wheelchair assessment and maintenance. One third were aware of regular review, attendant care, and similar programmes. The services that were least known were advocacy and supported accommodation. Consumer priorities were regular review and disability information services, while AHB priorities were attendant care and supported accommodation.


CONCLUSIONS
Lack of information, lack of regular assessment, and lack of coordination were major barriers to consumers obtaining adequate rehabilitation services. A single agency purchaser, clear entry points, case management and assessment would provide potent mechanisms for overcoming these difficulties. Priorities for consumers reflected their need for information and support, while provider priorities showed their commitment to the policy of de-institutionalisation. We conclude that it is important that consumers are involved in the planning process so that informed decisions are made about appropriate resource allocation.
Caradoc-Davies
T
T
Department of Medicine, University of Otago Medical School, Dunedin.
Hawker
A
A
D003258:Consumer Behavior / Q000706:statistics & numerical data*; D003695:Delivery of Health Care / Q000706:statistics & numerical data* / Q000639:trends; D006233:Persons with Disabilities / Q000534:rehabilitation*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009520:New Zealand