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Health Promotion International, Vol. 15, No. 1, 79-86,
March 2000
© Oxford University Press 2000
Promoting the health of people with physical disabilities: a discussion of the financing and organization of public health services in Australia
Health Economics, School of Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ, UK
Address for correspondence: Richard D. Smith, Health Economics, School of Health Policy & Practice, University of East Anglia, Norwich NR4 7TJ, UK, E-mail: Richard.Smith{at}uea.ac.uk
People with physical disabilities have a high probability of suffering secondary disabilities and disability-related acute health problems. Critically, they experience difficulties in access to health-promoting services. Of importance in reducing barriers to such services is the role of funding systems. There has been little research or comment in the area of funding, and this paper attempts to redress this imbalance by providing an overview of two specific systemic barriers in the funding of health promotion for those with disabilities in Australia: the method of service reimbursement and the disparate nature of funding sources. It is clear that there needs to be a revision of health care funding systems to enable an increase in the promotion of health amongst people with physical disabilities. Two possible solutions are considered: case-management and the increased involvement of private industry. The potential benefits of this are illustrated by reference to reducing unnecessary rehospitalization. With changes occurring in the Australian health care system, e.g. the move to case-mix funding and case-management, there is the potential for people with disabilities to either lose their access to health promotion further or to capitalize on these changes to ensure improvements. Either way it is clear that those involved with health promotion need to urgently address the issues raised in this paper in a timely fashion, to ensure that beneficial changes are capitalized upon and the potential for negative impacts is minimized.
Key words: disability; economics; funding; health promotion