Aligned or misaligned: Are public funding models for speech-language pathology reflecting recommended evidence? An exploratory survey of Australian speech-language pathologists

T Nickless; B Davidson; S Finch; L Gold; R Dowell

doi:10.1016/j.hpopen.2024.100117

Aligned or misaligned: Are public funding models for speech-language pathology reflecting recommended evidence? An exploratory survey of Australian speech-language pathologists

Health Policy Open. 2024 Mar 7:6:100117. doi: 10.1016/j.hpopen.2024.100117. eCollection 2024 Dec.

Authors

T Nickless^{1

2}, B Davidson¹, S Finch³, L Gold⁴, R Dowell^{1

5}

Affiliations

¹ Department of Audiology & Speech Pathology, The University of Melbourne, Australia.
² Word By Mouth Speech Pathology, Melbourne, Australia.
³ Statistical Consulting Centre, The University of Melbourne, Australia.
⁴ Deakin Health Economics, School of Health & Social Development, Deakin University, Australia.
⁵ The Royal Victorian Eye & Ear Hospital, Melbourne, Australia.

Abstract

Government subsidised funding arrangements serve as an essential medium for families to access private speech-language pathology (SLP) services in Australia. This study aimed to investigate whether, from a provider perspective, contemporary public funding models (PFMs) align with best-available scientific evidence for management of children and young persons with swallowing and communication disorders within Australian private-practice settings. This exploratory study was distributed to paediatric speech-language pathologists throughout Australia via an online survey. A total of 121 valid surveys were completed by Australian speech-language pathologists with divergent career experiences. In comparing three familiar PFMs using mixed effects logistic regression models to estimate odds ratios, results indicated that perceived congruence with recommended scientific evidence for SLP management varied across PFMs: the odds of failing to align with scientific evidence was 4.92 times higher for Medicare's Chronic Disease Management Plan (MBS_CDMP) than for the National Disability Insurance Scheme; and 7.40 times higher in comparison to Medicare's Helping Children with Autism initiative. This study is the first to report on (in)congruence between PFMs that provide access to independent Australian SLP services for children and young persons and best available scientific evidence to inform clinical practice. Participants identified that: (a) four out of seven contemporary PFMs were unfamiliar to speech-language pathologists; and (b) MBS_CDMP initiative failed to align with the evidence-base for best scientific SLP management.

Keywords: Public funding models; Quantitative research; Speech-language pathology.