Reduction of costs of disability using neuroprostheses

The lifetime costs associated with spinal cord injury are substantial. Assi stive technology that reduces complications, increases independence, or dec reases the need for attendant services can provide economic as well as medi cal or functional benefit. This study describes two approaches for estimati ng the economic consequences of implanted neuroprostheses utilizing functio nal electrical stimulation. Life care plan analysis was used to estimate th e costs of bladder and bowel care with and without a device restoring bladd er and bowel function and to compare these with the costs of implementing t he device. For a neuroprosthesis restoring hand grasp, the costs of impleme ntation were compared to the potential savings in attendant care costs that could be achieved by the use of the device. The results indicate that the costs of implementing the bladder and bowel system would be recovered in 5 years, primarily from reduced costs of supplies, medications, and procedure s. The costs of the hand grasp neuroprosthesis would be recovered over the lifetime of the user if attendant time was reduced only 2 hours per day and in a shorter time if attendant care was further reduced. Neither analysis includes valuation of the quality of life, which is further enhanced by the neuroprostheses through restoration of greater independence and dignity. O ur results demonstrate that implantable neuroprosthetic systems provide goo d health care value in addition to improved independence for the disabled i ndividual.