Cost analysis of assistive technology

The SCAI instrument was designed to help clinicians estimate the economic aspects of the provision of assistive technology (AT) solutions to individual users. Using the instrument involves three steps: 1) describing the objectives of the individual AT programme 2) establishing the sequence and the timing of all the interventions that form the programme and 3) compiling a cost calculation table for each AT solution. The last distinguishes between social costs (the sum of all material and human resources mobilised by the intervention) and the financial plan (the actual disbursement of money over time by all actors involved). The social cost is the main indicator of the economic significance of the AT solution: alternative solutions should be compared in terms of their social cost. The financial plan identifies the expenditure, i.e. the cash that should be dispensed by the funding actors during the programme lifecycle. The SCAI is not primarily intended as a decision-making tool; it ought to be looked at as an informative tool that adds to clinical assessment so as to make clinicians and users aware of the economic consequences of their decisions. The article also explores the possibility of using SCAI to compare different individual AT programs. Based on a survey of several individual AT programs carried out over a number of years, an attempt has been made to infer social cost indicators for various categories of AT equipment. The first clear finding is that – not surprisingly – most AT solutions, though very expensive in terms of initial purchase price, lead to considerable savings in social costs due to the reduced assistance burden. The second major finding is the marked variation in the social costs of different individual cases where similar AT solutions were implemented, suggesting difficulty in establishing repeatable social cost figures for a given device: such figures also depend on the individual context of the AT solution, and on its inter-relationship with the other AT solutions composing the whole program.