Wheelchairs, walkers, video magnifier, shower bar… Technical aids are a major issue for maintaining the autonomy of elderly and handicapped people. In France, users are supported in assessing their needs and financing their technical aids, but these measures are not always sufficient. The development of structures for the circularization of technical aids seems to provide elements of a response to the needs of users, but the development of these innovative systems is currently limited by the framework for the reimbursement of technical aids.
30% of technical aids abandoned in the first year of use
There are three main reasons for the dropout rate for technical aids:
– The user can no longer use it (institutionalization, death)
– The technical aid is no longer adapted to his or her needs (improvement or deterioration of his or her general condition)
– The user is unable to use it
In many cases, these situations lead to the purchase of a second technical aid, sometimes with a delay of several months in obtaining it. Thus, an inconsiderable number of perfectly working technical aids are discarded each year or stored in a corner of the home. The consequences are then financial losses for the user and the public financiers, a loss of autonomy for the user, but also an accumulation of waste, all of which can be avoided.
The circularization of technical aids as an answer to user needs
Like any object, technical aids can be part of a valorisation process according to the terms of the circular economy. In practice, once the technical aid is no longer used, the user or his helpers can drop it off at a collection point run by a specialized company or association. Depending on the state of the technical aid, the company or association will decide whether to refurbish it so that it can be reassigned (repair, cleaning and aseptization), or to dismantle it for spare parts.
The structure registered in such a reuse circuit will ultimately be able to offer the provision of low-cost technical aids and even customize these technical aids in its workshop so that they adapt perfectly to their new user, while helping to reduce greenhouse gas emissions linked to the production and scrapping of technical aids.
The multiplication of circularization projects in the territories
Based on this observation, many initiatives have been set up in the territories to deploy the circularization of technical aids. In 2015, the CNSA (National Solidarity Fund for Autonomy) launched a call for projects to support the innovative provision of technical aids, during which 10 initiatives were selected. Subsequently, 7 additional projects were evaluated by Alcimed and other territories are now involved in setting up projects.
Beyond the circularization of technical aids, these structures all offer a support service for the choice, installation, handling, and maintenance of the aid, working to ensure the proper use of technical aids and to reduce their abandonment rate. The use of these structures can also help reduce the time it takes to obtain technical aids, since less time is needed to restore them than to construct an aid.
The legislative changes necessary for the success of projects for the circularization of technical aids
Nevertheless, the current system for reimbursing technical aid, which only subsidizes new aid, does not facilitate the sustainability of such projects, which have difficulty establishing a self-supporting economic model. Indeed, it is sometimes more financially interesting for a user to purchase a brand new aid than to go to a circularization structure.
The 2020 Social Security Financing Law has recognized the interest of rehabilitating technical aids. A decree specifying the requirements concerning their restoration and the terms of repayment of these technical aids is currently being drafted and is expected in the fall. This text will revolutionize the technical aid sector by allowing the development of a circular economy, in the best interest of the user.
The circularization of technical aids thus makes it possible to alleviate many of the difficulties encountered by users in their journey to get technical aids. The legislative evolution on the reimbursement of these aids is imminent. It will enable the circularization structures to develop a sustainable economic model, to ensure the provision of personalized and low-cost technical aids, as well as quality support for users. Alcimed will be present to support these projects in their ramp-up, thanks to its expertise in the evaluation and design of innovative projects for the provision of technical aids.
About the authors
Juliette, Consultant in Alcimed’s Public Health Policy in France
Marie-Sophie, Project Manager in Alcimed’s Public Health Policy in France
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