title: A longitudinal comparison of consumer-directed and agency-directed personal assistance service programmes among persons with physical disabilities.
abstract: 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.
authors.affiliation: University of Missouri, Columbia, USA. clarkmj@health.missouri.edu
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Clark
authors.forename: Kristofer J
authors.initials: KJ
authors.lastname: Hagglund
authors.forename: Ashley K
authors.initials: AK
authors.lastname: Sherman
mesh_terms: 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