Addressing service deficits for the physically disabled in New Zealand: an action research study

As a consequence of the global trend towards new managerialism the New Zealand government undertook reforms of the health-care system during the 1980s and 1990s. These reforms, to a system that had functioned essentially unchanged since the 1930s, improved fiscal accountability at the expense of ensuring continuity of care. The restructuring particularly affected vulnerable populations with permanent disability and long-term health needs. This study sought to address the service deficits of the current health service delivery system and to identify strategies to ensure continuity of care for this group. The development of a clinical pathway and the appointment of a clinical care coordinator to oversee the delivery of comprehensive seamless health-care services were the major recommendations resulting from this study.