What is the cost of equity in assistive technology? A tool for calculating assistive products and services

This paper aims to address a technical conundrum in accurately costing and delivering assistive products and services in the context of market-shaping strategies designed to promote assistive technology (AT) access. Developed in response to Australian Government policy changes regarding provision of AT to community-dwelling older adults, the AT SERVE (Assistive Technology-Services, Equity, Resources, Valuation, and Enablement) Tool is introduced. This novel interdisciplinary approach informs equitable modelling of AT costs by incorporating both assistive products and essential services that enable the selection, fitting, maintenance, and outcome measurement vital for safe and effective use. The methodology utilised interdisciplinary systems thinking to bring together targeted, policy-focussed reviews of international and Australian statutes and practice guidelines. Key components included (1) assistive product classification; (2) delineation of service provision elements; (3) workforce cadres required for service delivery; (4) healthcare intervention guidance regarding rurality, indigeneity, assistive product complexity, and risk; and (5) applied health economics cost modelling appropriate for a government context. The exemplar presented relates to the Australian context but can be adapted to the intersectional factors relevant in any setting.