Access Barriers to Neurorehabilitation in a New Zealand TBI Population
Traumatic Brain Injury is a serious health problem in New Zealand that affects large numbers of people, comparable to other developed countries. Similarly, rehabilitation in New Zealand has been shown to dramatically reduce the impact of TBI on the individual and society. In New Zealand rehabilitation for patients with TBI is provided through the Accident Compensation Corporation – a government-run accident insurance scheme providing 24-hour/seven day per week no fault accident cover for all New Zealanders, including comprehensive rehabilitation.
In the presence of such a scheme, the patterns of access barriers to neurorehabilitation is different to that of other developed countries. This study examined patterns of access for patients living within the catchment area of a small city, including the rural hinterland surrounding it. The research shows that the presence of a physical disability comorbid to the TBI, Maori ethnicity, age 65+ and rural location were all positive predictors of access barriers to rehabilitation services.
Clients indicated that the provision of rehabilitation within a home environment would reduce these access difficulties, and would improve their ability to participate in a rehabilitation programme. Improving the cultural competence of therapists and doctors was also identified as a means for improving the accessibility of services for some Maori clients.
The research shows that while a comprehensive package of rehabilitation is available to be provided for all New Zealanders in the event of a TBI, the way in which this rehabilitation is provided still excludes some groups. This identifies a need to review the way in which rehabilitation is provided to better meet the needs of those who are elderly, Maori, physically disabled, and who live away from urban areas. Further research is indicated to identify whether increased home-based service provision for these client groups will improve their rehabilitative outcomes.