Assistive technology supports maintenance or improvement of an individual’s functioning and independence, though for people in need the access to assistive products is not always guaranteed. This paper presents a generic quality framework for assistive technology service delivery that can be used independent of the setting, context, legislative framework, or type of technology. Based on available literature and a series of discussions among the authors, a framework was developed. It consists of 7 general quality criteria and four indicators for each of these criteria. The criteria are: accessibility; competence; coordination; efficiency; flexibility; user centeredness, and infrastructure. This framework can be used at a micro level (processes around individual users), meso level (the service delivery scheme or programme) or at a macro level (the whole country). It aims to help identify in an easy way the main strengths and weaknesses of a system or process, and thus guide possible improvements. As a next step in the development of this quality framework the authors propose to organise a global consultancy process to obtain responses from stakeholders across the world and to plan a number of case studies in which the framework is applied to different service delivery systems and processes in different countries.
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Rationale, aims and objective: Primary Care Plus (PC+) focuses on the substitution of hospital-based medical care to the primary care setting without moving hospital facilities. The aim of this study was to examine whether population health and experience of care in PC+ could be maintained. Therefore, health-related quality of life (HRQoL) and experienced quality of care from a patient perspective were compared between patients referred to PC+ and to hospital-based outpatient care (HBOC). Methods: This cohort study included patients from a Dutch region, visiting PC+ or HBOC between December 2014 and April 2018. With patient questionnaires (T0, T1 and T2), the HRQoL and experience of care were measured. One-to-two nearest neighbour calliper propensity score matching (PSM) was used to control for potential selection bias. Outcomes were compared using marginal linear models and Pearson chi-square tests. Results: One thousand one hundred thirteen PC+ patients were matched to 606 HBOC patients with well-balanced baseline characteristics (SMDs <0.1). Regarding HRQoL outcomes, no significant interaction terms between time and group were found (P > .05), indicating no difference in HRQoL development between the groups over time. Regarding experienced quality of care, no differences were found between PC+ and HBOC patients. Only travel time was significantly shorter in the HBOC group (P ≤ .001). Conclusion: Results show equal effects on HRQoL outcomes over time between the groups. Regarding experienced quality of care, only differences in travel time were found. Taken as a whole, population health and quality of care were maintained with PC+ and future research should focus more on cost-related outcomes.
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Supermarkets are essential urban household amenities, providing daily products, and for their social role in communities. Contrary to many other countries, including nearby ones, the Netherlands have a balanced distribution of supermarkets across villages and urban neighbourhoods. However, spatial supermarket patterns, are subject to influential developments. First, due to economies of scale, there is a tendency for supermarkets to increase their catchment areas and to disappear from peripheral villages. Second, supermarkets are now mainly located in residential areas, although the urban periphery appears to be attractive for the retail sector, perhaps including the rise of hypermarkets. Third, today, online grocery shopping is still lagging far behind on other online shopping products, but a breaks through will dilute population support for in-store supermarkets and can lead to dramatic ‘game changer’ shifts with major spatial and social effects. These three important trends will reinforce each other. Consequences are of natural community meeting places at the expense of social cohesion; reduced accessibility for daily products, leading to more travel, often by car; increasing delivery flows; real estate vacancies, and increasing suburban demand increase for retail and logistics. Expected changes in supermarket patterns require understanding, but academic literature on OGS is still scarce, and does hardly address household behaviour in changing spatial constellations. We develop likely spatial supermarket patterns, and model the consequences for travel demand, social cohesion and real estate demand, as well as the distribution between online and in-store grocery shopping, by developing a stated preference experiment, among Dutch households.