Vertical and horizontal equity in support for children with disabilities: A cross-sectional analysis of Australia's national disability insurance scheme

Background Children with disabilities face persistent disadvantages in health, participation, and development. In Australia, the National Disability Insurance Scheme (NDIS) is a central funding mechanism for disability support. Equity is an explicit principle of the NDIS, yet concerns remain about whether access and experiences are equitable. Objectives This study examines equity in three outcomes of NDIS support for children with disabilities: (1) whether the child has a NDIS plan, (2) the level of plan funding, and (3) parental satisfaction with NDIS supports. We assess these outcomes through the lens of vertical and horizontal equity. Methods Data come from the 2024 Better Support for Kids with Disabilities survey (N=688 parents of children aged 2–17 years with disabilities). Logistic regression was used to model NDIS participation, ordinal logistic regression to model plan value, and linear regression to model satisfaction. Results Children with greater functional limitations were more likely to have a NDIS plan and to receive higher funding, indicating partial vertical equity. However, parents of children with greater functional limitations reported lower satisfaction. Horizontal equity was largely supported for the NDIS plan and funding outcomes, with few systematic disparities after accounting for functional limitations. Parents of older children, with fewer financial resources, and families including adults with disabilities reported lower satisfaction. Conclusions The NDIS appropriately directs greater resources toward children with higher needs, but inequities persist in satisfaction and experiences of support. Addressing disparities in navigation and service quality is essential to achieving equitable outcomes for all children with disabilities.