Factors influencing the experience of client-centeredness in flemish (Proxy) budget holders: a moderation analysis

Governments aim to stimulate care users/'budget holders' empowerment and decisional power by implementing cash-for-care schemes. Such a policy is theorized to reflect client-centered care, a pivotal theme in policy and practice.

This paper explores the association between empowerment (PE score) and client-centered care (CCCQ score), and the possible moderating effect of the PE score on the associations between the CCCQ scores and contextual factors (for example, budget height) in Flemish personal budget (PB) holders.

Respondents were recruited using convenience sampling and multiple recruitment sources. Bivariate and linear regression analyses with the total CCCQ score and scores of its previously found subscales (conduct by caregiver and autonomy) as dependent variables, and PE score, contextual, and sociodemographic variables as independent variables, were used.

The survey was completed by 224 respondents. Respondent type and the interaction term of budget height with PE score are associated with CCCQ total and autonomy scores. Searching for a suitable caregiver and interaction term of PB administrator type with PE score are associated with CCCQ total and conduct by caregiver scores. A positively rated financial situation is positively associated with CCCQ autonomy scores. However, CCCQ scores are not associated with PB type, information accessibility, or interaction terms of these variables with PE score.

This study demonstrates the importance of sufficiently large budgets and involving care users in PB management to achieve experiences of empowerment and client-centered care. Future research should further explore which other contextual factors affect this association.