The Cost‐Effectiveness of Supported Employment for People with Severe Intellectual Disabilities and High Support Needs: a Pilot Study

Abstract

The costs and outcomes of supporting seven people with severe intellectual disabilities and high support needs in part‐time employment were compared with those of a Special Needs Unit (SNU) of a day centre, both within‐subject and against an equal‐sized comparison group. The income of those employed was described. Direct observation of the employment activities and representative SNU activities were undertaken to assess participant engagement in activity and receipt of assistance, social contact in general and social contact from people other than paid staff. Costs of providing service support were calculated taking account of staff : service user ratios, staff identities and wage rates and service‐administrative and management overheads. Employment was associated with greater receipt of assistance, higher task‐related engagement in activity and more social contact from people other than paid staff. SNU activities were associated with greater receipt of social contact. Supporting people in employment was more expensive than in the SNU. Cost‐effectiveness ratios of producing assistance and engagement in activities were equivalent across the comparative contexts. The SNU was more cost‐effective in producing social involvement; employment in producing social contact from people other than paid staff.

Aproximación al análisis coste-beneficio entre empleo con apoyo y centros especiales de empleo mediante simulación comparativa con 24 trabajadores

“…Los análisis coste-beneficio proporcionan información sobre los costes de los servicios en relación a los beneficios que de éstos se derivan, para poder así tomar decisiones al comparar entre dos opciones de servicios para un objetivo similar (Beyer y Kilsby, 1998;Cimera, 2006aCimera, , 2007aCimera, , 2007bNarrillos, 2010;Shearn et al, 2000). Estos análisis son, por tanto, utilizados para aportar datos monetarios y permitirnos conocer qué opción es la más rentable, es decir, supone un mayor beneficio en relación al gasto realizado (Beyer y Kilsby, 1998;Cimera, 2010Cimera, , 2007aCimera, , 2007bShearn et al, 2000), siendo importante que ambas opciones sean equivalentes, o la comparación perdería la utilidad (Cimera, 2007a(Cimera, , 2007b. El problema de estos análisis es la mutabilidad, ya que en el momento que cambie una de las variables contempladas (subvenciones, aumentos salariales, cambio del valor monetario, etc.…”

“…Podemos encontrar evidencias de resultados (Beyer, 2012;Beyer et al, 1999;Cimera, 2012bCimera, , 2011aCimera, , 2011bCimera, , 2010Cimera, , 2009aCimera, , 2008Cimera, , 2007aCimera, , 2006aCimera y Burgess, 2011;Shearn et al, 2000) sobre los beneficios del ECA y sus mejores resultados respecto al empleo protegido desde las tres perspectivas de análisis citadas: persona, empresa y sociedad.…”

“…Estudios realizados en otros países, principalmente en los Estados Unidos, muestran que el ECA ofrecen mayor rentabilidad que los CEE (Cimera, 2006a(Cimera, , 2007a(Cimera, , 2008(Cimera, , 2009b(Cimera, , 2011a(Cimera, , 2012bShearn et al, 2000). La situación del empleo protegido es cualitativamente diferente en España, y nuestros CEE difieren de los talleres protegidos que funcionan en Estados Unidos.…”

“…UU. como una alternativa al empleo protegido, para la inserción laboral de las PCD (Beyer y Kilsby, 1998;Laloma, 2007;Shearn et al, 2000). Según la redefinición de 1998 de las Enmiendas de la Ley de Rehabilitación de 1986, el ECA estadounidense es un empleo en ambientes integrados de trabajo para personas que nunca han tenido un empleo competitivo, o para aquellas que lo han tenido de forma intermitente o lo han visto interrumpido como resultado de una discapacidad significativa, quienes, a causa de una discapacidad, necesitan servicios de empleo con apoyo.…”

Supported employment for persons with traumatic brain injury: A preliminary investigation of long-term follow-up costs and program efficiency

“…21 shown that supported employment is cost efficient (as well as cost effective when compared with sheltered workshops) for individuals with all types of disabilities, including individuals with severe disabilities. [21][22][23][24][25][26][27][28] Further, the cost efficiency of supported employment programs increases with each year of program operation, with the benefits of supported employment exceeding the costs by the fourth year of operation. 21 Information regarding the long-term costs of supported employment services as well as the long-term benefits to consumers is crucial in determining the efficacy of supported employment in individuals with TBI.…”