Promoting the health of people with physical disabilities: a discussion of the financing and organization of public health services in Australia

People with physical disabilities have a high probability ofsuffering secondary disabilities and disability-related acutehealth problems. Critically, they experience difficulties inaccess to health-promoting services. Of importance in reducingbarriers to such services is the role of funding systems. Therehas been little research or comment in the area of funding,and this paper attempts to redress this imbalance by providingan overview of two specific systemic barriers in the fundingof health promotion for those with disabilities in Australia:the method of service reimbursement and the disparate natureof funding sources. It is clear that there needs to be a revisionof health care funding systems to enable an increase in thepromotion of health amongst people with physical disabilities.Two possible solutions are considered: case-management and theincreased involvement of private industry. The potential benefitsof this are illustrated by reference to reducing unnecessaryrehospitalization. With changes occurring in the Australianhealth care system, e.g. the move to case-mix funding and case-management,there is the potential for people with disabilities to eitherlose their access to health promotion further or to capitalizeon these changes to ensure improvements. Either way it is clearthat those involved with health promotion need to urgently addressthe issues raised in this paper in a timely fashion, to ensurethat beneficial changes are capitalized upon and the potentialfor negative impacts is minimized.