title: Impact of consumer-directed care on quality of life in the community aged care sector.
abstract: OBJECTIVE
  All consumer-directed care (CDC) models aim to transfer "choice" and "control" over the allocated funds from the aged care provider to service recipients. This study presents an empirical assessment of the relationships between quality of life for older adults aged ≥65 years receiving community aged care services in Australia under CDC compared with those receiving traditional provider-directed care (PDC).
  
  
  METHODS
  Self-reported quality of life (health status and capabilities) were measured for older adults receiving community aged care services (n = 139) using the EuroQoL five dimensions five-level version and the older people-specific capability index (ICECAP-O) instruments. The relationship between quality of life, mode of service delivery, and other sociodemographic characteristics were examined using descriptive statistical and multivariate regression analyses.
  
  
  RESULTS
  The quality of life of individuals receiving CDC and PDC was similar (ICECAP-O: CDC mean 0.74 [SD 0.17], PDC mean 0.78 [SD 0.17]. EuroQoL five dimensions five-level version: CDC mean 0.46 [SD 0.33], PDC mean 0.49 [SD0.27]). In general, individuals in receipt of CDC reported higher levels of capability in the control and independence dimension for the ICECAP-O relative to those receiving PDC. Multivariate regression analysis showed that living alone was associated with higher quality of life (P = 0.01) and higher levels of capability (P = 0.02).
  
  
  CONCLUSIONS
  Although no discernible differences in overall quality of life were found, higher levels of self-reported control and independence for those in receipt of CDC suggest that the main policy objectives of transferring "choice" and "control" away from the aged care provider and to the individual are being met. Geriatr Gerontol Int 2017; 17: 1399-1405.
authors.affiliation: Flinders Health Economics Group, School of Medicine, Flinders University, Repatriation General Hospital, Adelaide, South Australia, Australia.
authors.forename: Norma
authors.initials: N
authors.lastname: Bulamu
authors.affiliation: Flinders Health Economics Group, School of Medicine, Flinders University, Repatriation General Hospital, Adelaide, South Australia, Australia.
authors.forename: Billingsley
authors.initials: B
authors.lastname: Kaambwa
authors.affiliation: John Walsh Center for Rehabilitation Research, Sydney Medical School Northern, University of Sydney, Kolling Institute of Medical Research, Royal North Shore Hospital, Sydney, New South Wales, Australia.
authors.forename: Liz
authors.initials: L
authors.lastname: Gill
authors.affiliation: John Walsh Center for Rehabilitation Research, Sydney Medical School Northern, University of Sydney, Kolling Institute of Medical Research, Royal North Shore Hospital, Sydney, New South Wales, Australia.
authors.forename: Ian
authors.initials: I
authors.lastname: Cameron
authors.affiliation: Resthaven Incorporated, Adelaide, South Australia, Australia.
authors.forename: Sue
authors.initials: S
authors.lastname: McKechnie
authors.affiliation: Aged Care and Housing, Adelaide, South Australia, Australia.
authors.forename: Jeff
authors.initials: J
authors.lastname: Fiebig
authors.affiliation: Catholic Community Services, Adelaide, New South Wales, Australia.
authors.forename: Robin
authors.initials: R
authors.lastname: Grady
authors.affiliation: Flinders Health Economics Group, School of Medicine, Flinders University, Repatriation General Hospital, Adelaide, South Australia, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Ratcliffe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006299:Health Services for the Aged / Q000458:organization & administration*; D006304:Health Status; D006801:Humans; D008297:Male; D009517:New South Wales; D011788:Quality of Life; D057566:Self Report; D012959:Socioeconomic Factors; D013021:South Australia; D011795:Surveys and Questionnaires
keywords: aged; community aged care; consumer directed care; quality of life