Certified service dogs – A cost-effectiveness analysis appraisal

Introduction Individuals with functional impairments or chronic diseases are often in need of assistance in their daily lives. For these individuals it is essential to find novel, cost-effective solutions to meet their needs. Service dogs are dogs that are specially trained to assist individuals with functional impairments and may be able to improve these individuals’ quality of life at a reasonable cost, i.e. be cost effective. Cost-effectiveness analyses are used to illustrate the cost of an intervention in relation to its effects and provide important input to decision-makers when setting priorities. Aim The aim of this study is to assess the cost effectiveness of a certified physical service dog and a diabetes alert dog compared to a regular companion dog. Method Costs, life years and quality-adjusted life years were estimated over a 10-year time horizon using a decision-analytic model built upon evidence from the”service and hearing dog project”. The primary outcome was the incremental cost-effectiveness ratio expressed as cost per gained quality-adjusted life year. The analysis was conducted from a societal perspective. Costs and effects were discounted with 3% per annum and reported in USD. Results Compared to a regular companion dog, a physical service dog is cost saving [-6,000 USD] and gives the dog owner more quality-adjusted life years [0.28]. The diabetes alert dog is also cost effective in comparison with a regular companion dog [-4,500 USD, 0.06 QALYs]. Conclusion This study indicates that a certified service dog is cost saving in comparison with a regular companion dog for individuals with functional impairments or chronic diseases. The uncertainty of the analysis implies that further studies are needed in order to confirm these results. Nevertheless, physical service dogs and diabetes alert dogs show potential to be a valuable support and decision analytic models are useful tools to provide this information.引言 存在功能障碍或慢性病的个体在日常生活中往往需要协助。对于这类人群而言，寻找新颖且具备成本效益的解决方案以满足其需求至关重要。服务犬是经过专门训练以协助功能障碍个体的犬只，能够以合理成本提升这类人群的生活质量，即具备成本效益。成本效益分析用于阐明干预措施的成本与其效果之间的关联，可为决策者制定优先级提供重要参考依据。 研究目的 本研究旨在评估认证肢体服务犬与糖尿病警示犬（Diabetes Alert Dog）相较于普通伴侣犬的成本效益情况。 研究方法 本研究基于「服务与听障犬项目（Service and Hearing Dog Project）」的证据构建决策分析模型，对10年时间跨度内的成本、生命年与质量调整生命年（Quality-Adjusted Life Year, QALY）进行估算。主要结局指标为增量成本效果比，以每获得1个质量调整生命年所需成本表示。本研究从社会视角开展分析，成本与效果均按每年3%的比例进行贴现，并以美元计价报告。 研究结果 相较于普通伴侣犬，认证肢体服务犬可节约成本[-6000美元]，并为犬主带来更多的质量调整生命年[0.28]。与普通伴侣犬相比，糖尿病警示犬同样具备成本效益[-4500美元，0.06 QALYs]。 研究结论 本研究表明，针对存在功能障碍或慢性病的个体，认证服务犬相较于普通伴侣犬可节约成本。本分析存在不确定性，需开展进一步研究以验证上述结果。尽管如此，肢体服务犬与糖尿病警示犬均展现出作为有效支持手段的潜力，而决策分析模型则是提供此类信息的实用工具。