Quality, choice and outcomes in assistive technology (AT) equipment funding schemes: a procurement case study.

Abstract

Background: Delivering merit goods such as assistive technology devices (AT devices) is a challenge for government AT funding schemes, who are expected to deliver appropriate AT devices while managing costs and ever increasing demand. Is it possible to provide individualized AT devices, in the context of streamlined supply and cost containment? Method: This paper considers this question by examining the actions of two Australian government state-based AT funding schemes, which embarked on a bi-jurisdictional strategic procurement plan for a range of non-customised high volume assistive technology (AT). Results: This procurement process effectively limits choice of AT devices to a subset of quality, repairable and re-issuable AT devices. The decision to move to bulk procurement, the processes used and the outcomes to date are presented from the perspective of AT funding schemes, and discussed in light of the perspectives of AT suppliers and AT prescribers, including occupational therapists. Conclusion: The paper argues that limiting supply according to a set of quality measures is justified, and invites dialogue as to how to ensure AT best practice within procurement contexts.