Cost analysis of assistive technology and other enviromental facilitators: the SCAI (Siva Cost Analysis Instrument)

The SCAI instrument was designed to help clinicians estimate the economic aspects of the provision of assistive technology (AT) solutions to individual users. Use of 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 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.