Cost-utility analysis of assistive technology - Report on the CERTAIN project

The TIDE CERTAIN project (Cost-Effective Rehabilitation through Appropriate Indicators) was carried out during the period 1994 - 1996. Its over-all objective was to provide a user-oriented method to evaluate costs and user benefits with regard to assistive technologies (AT). The project was restricted to generic outcome measures based on user preferences through the utility analysis method. On the cost side, a broad approch accounting for societal costs, including direct and indirect costs, was to be taken. Achievements were made in four main groups: 1) Critical factors to ensure optimal benefits of assistive technology (AT) were identified. Outcomes as experienced by end users, family members, social networks, service providers, financing agencies, central authorities and otherswere analysed. This work constitutes the basis for cost-utility studies. 2) A taxonomy for socio-economic evaluation was developed, called "the CERTAIN tool". It provides guidelines for how to provide information on costs and social benefits with a focus on the users' satisfaction and quality of life. 3) The "CERTAIN tool" was evaluated through application retrospectively to a number of real life case studies of provision of AT to disabled persons. It was found that the critical factors analysis is applicable to case reporting and that the guidelines derived for cost analysis are applicable. 4) A feasibility study was made through the application of "the CERTAIN tool" to TIDE technology development projects. The results of the validation phase confirm that a technique for carrying out cost-utility analysis is possible, although more work is needed to elaborate it. It was concluded that, due to identified deficits of existing outcome instruments, the taxonomy for socio-economic evaluation needs more development. As to the methodology for assessing the costs not much more development seems to be necessary. It might be useful to have a more systematic description of what elements of costing are recommended depending on the subject and goal of the study.