A qualitative study to evaluate strategies for changes in the assistive technology service delivery in Flanders.

Assistive technology (AT) is an important aid in the daily functioning of persons with disabilities [1]. It can improve independence of the user by facilitating daily tasks [2], reducing the amount of personal assistance needed [3], and decrease caregiver burden [4,5]. Because of recent progress in the development and production of specialized AT in categories such as mobility [6] and cognitive function [7], AT has the potential to support a very wide group of users. Also, in a population that is consistently growing older, more persons will require functional aid products to maintain an independent lifestyle [8]. Previous research has already shown the cost-effectiveness of AT in community-based populations of elderly persons [9]. Consequently, both the expansion of AT products and the growth in the number of users translates into a higher financial burden for the government to subsidize these new and often expensive products. In the Flemish healthcare system new financial delivery models and improved efficiency of AT use are necessary to guarantee a good quality of care [10]. One of the current problems is the nonuse of AT that are disposed to them [11,12]. Previous research has already inventoried diverse reasons for users to not use their AT [13,14]. A possibility to address nonuse could be the optimization of service delivery [15]. In other countries, reuse and recycling of AT have been considered, and these concepts have proven to be effective [16,17]. Also in a recent report of the Association for the Advancement of Assistive Technology in Europe (AAATE), it is advocated to study how service delivery can be optimized [18]. This study aims to inventory thoughts and opinions of various stakeholders and users in the service delivery process in Flanders concerning 1) the present model of AT service delivery, 2) possible future changes that can make this model more cost-efficient, such as reuse/recycling of AT, and 3) the registration and tracking of AT use.