A longitudinal comparison of consumer-directed and agency-directed personal assistance service programmes among persons with physical disabilities.
OBJECTIVE
To compare outcomes for persons who were enrolled in an agency-directed personal assistance services (PAS) programme and then changed to a consumer-directed PAS programme.


METHODS
A convenience sample was used for this longitudinal study. In-home interviews were conducted by a trained data collector from April 2000 to December 2001.


RESULTS
Participants reported more satisfaction and safety with personal assistance, and fewer unmet needs after receiving consumer-directed services than after receiving agency-directed services. Other variables related to outcomes included race and ethnicity, employment, functional status, unmet needs, and the level of confidence in obtaining help if assistance is unavailable. Participants (74%) also reported high rates of unmet needs in the past month.


CONCLUSIONS
Consumer-directed PAS enhances outcomes for many persons with disabilities. Self-reported outcomes are affected by many factors that could be addressed in PAS program development.
Clark
Mary J
MJ
University of Missouri, Columbia, USA. clarkmj@health.missouri.edu
Hagglund
Kristofer J
KJ
Sherman
Ashley K
AK
D000203:Activities of Daily Living; D000328:Adult; D006233:Persons with Disabilities; D005260:Female; D018574:Home Care Agencies; D018576:Home Health Aides; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D017060:Patient Satisfaction