title: Consumer Directed Care in Australia: early perceptions and experiences of staff, clients and carers.
abstract: The study aimed to identify the shared issues and challenges being experienced by staff, their clients and informal carers, with the introduction of Consumer Directed Care (CDC). Secondary analysis was undertaken of data that had been initially collected, via semi-structured in-depth interviews, to inform the development of a discrete choice experiment. The raw staff and client/carer data were re-examined using an iterative inductive process. The analysis focused on locating the shared themes and differences between the participant groups based on their CDC experience. The data were also assessed for difficulties or barriers that impacted on the service. Four broad shared themes were derived: culture, role change, operational systems and resourcing, but with a range of diverse and sometimes conflicting sub-themes between the different participant groups. Differences can be linked to participant role in the service chain, with discordance emerging between what has been traditionally offered and what might be possible. This investigation occurred during the period in which services were transitioning from a traditional aged care service model to a new model of service provision requiring considerable industry change. We conclude that existing industry regulation, culture and practice supports an established service model in Australia that arguably makes translation of the objectives of CDC difficult.
authors.affiliation: John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, The University of Sydney, Australia.
authors.forename: Liz
authors.initials: L
authors.lastname: Gill
authors.affiliation: Flinders Health Economics Group (FHEG), School of Medicine, Flinders University, Daws Road, Daw Park, South Australia.
authors.forename: Nikki
authors.initials: N
authors.lastname: McCaffrey
authors.affiliation: John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, The University of Sydney, Australia.
authors.forename: Ian D
authors.initials: ID
authors.lastname: Cameron
authors.affiliation: Flinders Health Economics Group (FHEG), School of Medicine, Flinders University, Daws Road, Daw Park, South Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Ratcliffe
authors.affiliation: Flinders Health Economics Group (FHEG), School of Medicine, Flinders University, Daws Road, Daw Park, South Australia.
authors.forename: Billingsley
authors.initials: B
authors.lastname: Kaambwa
authors.affiliation: Director Research & Development, Helping Hand Aged Care, North Adelaide, South Australia.
authors.forename: Megan
authors.initials: M
authors.lastname: Corlis
authors.affiliation: General Manager, Major Initiatives, ACH Group, 22 Henley Beach Road, Mile End, South Australia.
authors.forename: Jeff
authors.initials: J
authors.lastname: Fiebig
authors.affiliation: Research and Design, Hammond Care, 447 Kent Street, Sydney, New South Wales, Australia.
authors.forename: Meredith
authors.initials: M
authors.lastname: Gresham
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D017028:Caregivers / Q000706:statistics & numerical data*; D002755:Choice Behavior; D003469:Culture; D005260:Female; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D010465:Perception
keywords: Consumer directed care (CDC); challenges; culture; operational systems; resourcing; role change