Factors influencing the experience of empowerment in Flemish (proxy) budget holders: A regression analysis

IF 3.6 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Health Policy Pub Date : 2025-03-04 DOI:10.1016/j.healthpol.2025.105295

Eva Pattyn , Paul Gemmel , Ruben Willems , Susan Lagaert , Jeroen Trybou

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Abstract

The Flemish government implemented a cash-for-care scheme in 2017, allocating a personal budget (PB) as a voucher or cash budget to persons with physical and intellectual disabilities to increase budget holders’ empowerment. However, the literature shows that personal (inherent to budget holders) and contextual factors (inherent to cash-for-care schemes) potentially have an impact. This study, therefore, reports on Flemish budget holders’ empowerment and its associated factors. A survey was developed, examining personal and contextual factors related to empowerment. A convenience sample with multiple recruitment sources (via policy, user-, and care organization support) was used to recruit participants. Data collection took place from April 4, 2022, to October 31, 2022, and data were analyzed using bivariate and linear regression analyses. The survey was completed by 224 budget holders. The complexity of administrative procedures, educational level, private financial resources, and presence of an (in)formal care network were not associated with Flemish budget holders’ empowerment. However, the regression analyses showed that knowledge of the care and well-being sector, PB allocation type (cash and combination versus vouchers), and respondent type (proxies representing the budget holder versus people with disabilities as respondents) predicted empowerment. Knowledge and flexibility in PB use are significantly associated with higher empowerment scores. Enhancing knowledge about the (disability) care sector is thus a key objective when implementing a cash-for-care scheme.

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影响佛兰芒（代理）预算持有人赋权经验的因素：回归分析

佛兰德政府于2017年实施了一项现金换医疗计划，将个人预算作为代金券或现金预算分配给身体和智力残疾者，以增强预算持有人的权能。然而，文献表明，个人因素（预算持有人固有的）和环境因素（医疗现金计划固有的）可能会产生影响。因此，本研究报告了佛兰德预算持有人的权力及其相关因素。开展了一项调查，审查与授权有关的个人因素和环境因素。使用具有多个招募来源（通过政策、用户和护理组织支持）的方便样本来招募参与者。数据收集时间为2022年4月4日至2022年10月31日，数据采用双变量和线性回归分析。这项调查由224名预算负责人完成。行政程序的复杂性、教育水平、私人财政资源和是否存在正式护理网络与佛兰德预算持有人的权力无关。然而，回归分析表明，护理和福利部门的知识、PB分配类型（现金和组合与代金券）和受访者类型（代表预算持有人与作为受访者的残疾人的代理）预测了赋权。知识和灵活性的PB使用与更高的授权得分显著相关。因此，加强对（残疾）护理部门的了解是实施现金换护理计划的一个关键目标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Policy 医学-卫生保健

CiteScore

6.40

自引率

6.10%

发文量

157

审稿时长

3-8 weeks

期刊介绍： Health Policy is intended to be a vehicle for the exploration and discussion of health policy and health system issues and is aimed in particular at enhancing communication between health policy and system researchers, legislators, decision-makers and professionals concerned with developing, implementing, and analysing health policy, health systems and health care reforms, primarily in high-income countries outside the U.S.A.