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. 2018 Jun 26;18(1):148.
doi: 10.1186/s12877-018-0838-8.

How do clients in Australia experience Consumer Directed Care?

Liz Gill  1 , Sandra L Bradley  2 , Ian D Cameron  3 , Julie Ratcliffe  4
Affiliations

How do clients in Australia experience Consumer Directed Care?

Liz Gill et al. BMC Geriatr. .

Abstract

Background: Our study explored client experience of Australian Consumer Directed Care. This evolving funding model enables consumer autonomy and choice, allowing older people to remain in their community as they age and need support through the creation of a personalised support service. Consumer Directed Care focuses on providing services that the consumer self-determines to meeting their needs including identifying their types of services, from whom, when and how these services are delivered.

Methods: Semi-structured in-depth interviews were conducted in two Australian states between August 2015 and April 2016 with 14 participants, preferably in receipt of CDC services for at least the previous 12 months. Questions explored how the participant first learned about this service; the types of services they received; whether services met their needs; and any additional support services they personally purchased. Interviews were transcribed, coded and thematically analysed.

Results: Four main themes related to consumer experience emerged. Knowledge: Unsure what Consumer Directed Care Means. Acceptance: Happily taking any prescriptive service that is offered. Compliance: Unhappily acceding to the prescriptive service that is offered. External Influences: Previous aged care service experience, financial position, and cultural differences.

Conclusion: Our results suggest that the anticipated outcomes of Consumer Directed Care providing a better service experience were limited by existing client knowledge of these services, how best to utilise their funding allocation, and their acceptance or compliance with what was offered, even if this was not personalised or sufficient. External influences, such as service experience, finances, cultural difference, impacted the way clients managed their allocation. Our study identified that ongoing engagement and discussion with the client is required to ensure that services are specific, directly relevant and effective to achieving a consumer directed care service.

Keywords: Australia; Clients; Community; Consumer directed care; Thematic.

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Conflict of interest statement

Authors’ information

Liz Gill, Dip PT, BSc PT, MBA, MA and PhD, is a Research Fellow. She has worked as a health professional in the areas of direct service provision; health system design; policy and consulting. Her research interests are in the areas of service co-creation in health services, and the role and contribution of the client to health service quality and service outcomes.

Sandra Bradley, RN, BSc, BArts, BN, Masters (Research) and PhD is a Research Fellow conducting research in all areas of end of life care. With both qualitative and quantitative research skills her areas of interest focus on the decision-making that occurs by people assessing end of life care options.

Ian Cameron, MBBS PhD FAFRM (RACP), is a Consultant Physician in Rehabilitation Medicine, Chair in Rehabilitation Medicine and Head of the Rehabilitation Studies Unit, Sydney Medical School, at the University of Sydney. Ian has a National Health and Medical Research Council Practitioner Fellowship and is a clinician researcher.

Julie Ratcliffe, BA Hons and PhD is Professor in Health Economics at the Institute for Choice, University of South Australia. She has a strong track record in health economics research and teaching. Areas of research expertise include measurement & valuation of health outcomes, new/emerging healthcare technologies and healthcare preferences.

Ethics approval and consent to participate

This study was approved by the Flinders University Social and Behavioural Research Ethics Committee (Project Number 6448). Written consent to participate was obtained from all participants.

Consent for publication

Not applicable.

Competing interests

Ian Cameron is a member of the editorial board.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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