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Roquebert Q, Tenand M. Informal care at old age at home and in nursing homes: determinants and economic value. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024; 25:497-511. [PMID: 37296350 PMCID: PMC10972991 DOI: 10.1007/s10198-023-01601-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 05/24/2023] [Indexed: 06/12/2023]
Abstract
This paper provides a comprehensive analysis of informal care receipt by the French individuals aged 60 or older. The literature has focused on the community, leaving informal care in residential care settings in the shadow. We leverage data from a representative survey (CARE) conducted in 2015-2016 on both community-dwelling individuals and nursing home residents. Focusing on the 60+ with activity restrictions, we show that 76% of nursing home residents receive help with the activities of daily living from relatives, against 55% in the community. The number of hours conditional on receipt is yet 3.5 times higher in the community. Informal care represents 186 million hours per month and a value equivalent to 1.1% of GDP at least, care in the community representing 95% of the total. We investigate the determinants of informal care receipt. Using an Oaxaca-type approach, we disentangle between two mechanisms explaining that nursing home residents are more likely to receive informal care, namely the differences in population composition (endowments) and the differences in the association of individual characteristics with informal care (coefficients). Both are found to have a similar contribution. Our results imply that private costs make up for the majority (76%) of the costs associated with long-term care provision once informal care is taken into account. They also highlight that informal care is extremely common for nursing home residents. Existing evidence on the determinants of informal care receipt in the community has, however, limited relevance to understand informal care behaviors in nursing homes.
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Affiliation(s)
- Quitterie Roquebert
- Université de Strasbourg, Université de Lorraine, CNRS, BETA, 67000, Strasbourg, France
| | - Marianne Tenand
- Erasmus School of Health Policy & Management (ESHPM), Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam (EUR) and the Netherlands Bureau for Economic Policy Analysis (CPB), Rotterdam and The Hague, The Netherlands.
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Gómez Maldonado L, de Mora-Figueroa R, López-Angarita A, Maravilla-Herrera P, Merino M. Cost of Patients with Alzheimer's Disease in Spain According to Disease Severity. PHARMACOECONOMICS - OPEN 2024; 8:103-114. [PMID: 37966711 PMCID: PMC10781927 DOI: 10.1007/s41669-023-00451-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/29/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) has been associated with great healthcare and non-healthcare resource consumption. The aim of this study was to estimate the burden of AD in Spain according to disease severity from a societal perspective. METHODS A self-administered questionnaire was designed by the researchers and completed by the informal caregivers of patients with AD, reporting data on themselves as caregivers and on the AD patients for whom they care. The patients' sociodemographic and clinical data, their healthcare and non-healthcare resource consumption in the previous 12 months, and the impact of the disease on labor productivity were compiled. Data collected on informal caregivers included sociodemographic data and the impact of caring for a person with AD on their quality of life and labor productivity. Costs were estimated by multiplying the number of consumed resources by their unit prices. The cost of informal care was assessed using the proxy good method, and labor productivity losses were estimated using the human capital method. Costs were estimated by disease severity and are presented per patient per year in 2021 euros (€). RESULTS The study sample comprised 171 patients with AD aged 79.1 ± 7.4 years; 68.8% were female, time from diagnosis was 5.8 ± 4.1 years, diagnosis delay was 1.8 ± 2.3 years, and the mean Cumulative Illness Rating Scale-Geriatric (CIRS-G) total was score 8.2 ± 6.0. According to disease severity, 14% had mild cognitive impairment or mild AD, 43.9% moderate AD, and 42.1% severe AD. The average annual cost per patient was €42,336.4 in the most conservative scenario. The greatest proportion of this cost was attributed to direct non-healthcare costs (86%, €36,364.8), followed by direct healthcare costs (8.6%, €3647.1), social care costs (4.6%, €1957.1), and labor productivity losses (less than 1%, €367.4). Informal care was the highest cost item, representing 80% of direct non-healthcare costs and 69% of the total cost. The total direct non-healthcare cost and total cost were significantly higher in moderate to severe disease severities, compared to milder disease severity. CONCLUSIONS AD poses a substantial burden on informal caregivers, the national healthcare system, and society at large. Early diagnosis and treatment to prevent disease progression could reduce this economic impact.
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Affiliation(s)
| | | | | | | | - María Merino
- Vivactis Weber, C/ Moreto, 17-5º dcha, 28014, Madrid, Spain.
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Ramezani-Doroh V, Karimi F, Rangchian M, Hamidi Y. Monetary valuation of COVID-19 informal care: caregivers' willingness to pay and willingness to accept. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2023; 21:22. [PMID: 37013619 PMCID: PMC10069359 DOI: 10.1186/s12962-023-00437-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Informal care can reduce hospitalization frequency and time, elevate bed turnover, and increase the health systems' capacity. This type of care has shown meaningful value in managing many cases through the COVID-19 pandemic. The present study aimed to identify determinants of monetary valuation of informal care and the burden of this care on the COVID-19 patients' caregivers. METHODS Through a cross-sectional phone survey from June to September 2021 in Sanandaj city, the west of Iran, COVID-19 patients and their caregivers (Each Group No. 425) were separately interviewed. A simple probabilistic sampling method was applied. Two questionnaires were developed and used after validation. Monetary valuation of informal caregivers was done using Willingness to pay (WTP) and willingness to accept (WTA). Double hurdle regressions were used to determine related variables to WTP/WTA. R software was used for the data analysis. RESULTS The total mean (Standard Deviation) of WTP and WTA were $12.02(28.73), $10.30(15.43) USD. Most respondents put a zero value on informal care by WTA (243(57.18%) and WTP [263 (61.88%)]. Caregivers' Employment, and being spouse/child of the care recipient increased the probability of reporting a positive value for WTP (p-value < 0.0001, p-value = 0.011 respectively) and WTA (p-value = 0.004, p-value < 0.0001 respectively). An increase in the number of caring days decreased the probability of reporting positive WTA (p-value = 0.001) and increased the mean of lnWTP (p-value = 0.044). Perceived difficulty in doing indoor activities and perceived difficulty in doing outdoor activities decreased lnWTA mean (p-value = 0.002) and lnWTP mean (p-value = 0.043) respectively. CONCLUSIONS Increasing caregivers' self-efficacy and facilitating their involvement in the caring process could be facilitated through flexible work status, educational programs, and interventions on decreasing their burnout.
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Affiliation(s)
- Vajiheh Ramezani-Doroh
- Department of Health Management and Economics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Faride Karimi
- Department of Health Management and Economics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Rangchian
- Department of Clinical Pharmacy, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Yadolah Hamidi
- Department of Health Management and Economics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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Jönsson L, Tate A, Frisell O, Wimo A. The Costs of Dementia in Europe: An Updated Review and Meta-analysis. PHARMACOECONOMICS 2023; 41:59-75. [PMID: 36376775 PMCID: PMC9813179 DOI: 10.1007/s40273-022-01212-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND AND OBJECTIVE The prevalence of dementia is increasing, while new opportunities for diagnosing, treating and possibly preventing Alzheimer's disease and other dementia disorders are placing focus on the need for accurate estimates of costs in dementia. Considerable methodological heterogeneity creates challenges for synthesising the existing literature. This study aimed to estimate the costs for persons with dementia in Europe, disaggregated into cost components and informative patient subgroups. METHODS We conducted an updated literature review searching PubMed, Embase and Web of Science for studies published from 2008 to July 2021 reporting empirically based cost estimates for persons with dementia in European countries. We excluded highly selective or otherwise biased reports, and used a random-effects meta-analysis to produce estimates of mean costs of care across five European regions. RESULTS Based on 113 studies from 17 European countries, the estimated mean costs for all patients by region were highest in the British Isles (73,712 EUR), followed by the Nordics (43,767 EUR), Southern (35,866 EUR), Western (38,249 EUR), and Eastern Europe and Baltics (7938 EUR). Costs increased with disease severity, and the distribution of costs over informal and formal care followed a North-South gradient with Southern Europe being most reliant on informal care. CONCLUSIONS To our knowledge, this study represents the most extensive meta-analysis of the cost for persons with dementia in Europe to date. Though there is considerable heterogeneity across studies, much of this is explained by identifiable factors. Further standardisation of methodology for capturing resource utilisation data may further improve comparability of future studies. The cost estimates presented here may be of value for cost-of-illness studies and economic evaluations of novel diagnostic technologies and therapies for Alzheimer's disease.
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Affiliation(s)
- Linus Jönsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden.
| | - Ashley Tate
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | - Oskar Frisell
- Institute of Health Economics (IHE), Stockholm, Sweden
| | - Anders Wimo
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
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Frederiksen KS, Lanctôt KL, Weidner W, Hahn-Pedersen JH, Mattke S. A Literature Review on the Burden of Alzheimer's Disease on Care Partners. J Alzheimers Dis 2023; 96:947-966. [PMID: 37980660 DOI: 10.3233/jad-230487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
BACKGROUND Many individuals with Alzheimer's disease (AD) are dependent on nonprofessional care partners. Providing informal care can result in emotional, physical, and financial burdens; however, there is a need for a better understanding of the impact of AD on care partners to support the clinical and economic assessment of potential new treatments. OBJECTIVE We conducted a literature review to evaluate the burden experienced by care partners of individuals with AD. METHODS Electronic screening and supplementary searches identified studies published from 2011 to 2022 describing the association between AD and the quality of life (QoL) and physical health of care partners, and the economic or financial burden of AD. RESULTS Following electronic screening, 62, 25, and 39 studies were included on care partner burden, cost, and healthcare resource use in AD, respectively. Supplementary searches identified an additional 32 studies, resulting in 149 unique studies. These studies showed that care partners of individuals with AD report moderate to severe burden. Higher burden and lower QoL were observed in those caring for individuals with more severe AD. Care partners of individuals with AD experience higher burden, lower QoL, and higher levels of stress, depression, and anxiety than those without caring responsibilities. Informal care costs increased with AD severity and accounted for the greatest proportion of overall societal cost. CONCLUSIONS Care partners of individuals with AD experience emotional and economic burden, which increases with AD severity. These impacts should be quantified comprehensively in future studies and captured in economic evaluations of AD interventions.
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Affiliation(s)
- Kristian Steen Frederiksen
- Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Krista L Lanctôt
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | | | | | - Soeren Mattke
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, US
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Ejaz SA, Fayyaz A, Mahmood HMK, Aziz M, Ejaz SR, Alkhuriji AF, Al-Megrin WAI, Aborode AT, Batiha GES. 4-Phthalimidobenzenesulfonamide Derivatives as Acetylcholinesterase and Butyrylcholinesterase Inhibitors: DFTs, 3D-QSAR, ADMET, and Molecular Dynamics Simulation. NEURODEGENER DIS 2022; 22:122-138. [PMID: 36288689 DOI: 10.1159/000527516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/26/2022] [Indexed: 10/10/2023] Open
Abstract
INTRODUCTION Alzheimer's disease is a form of dementia which affects majority of the people. It is characterized by memory loss and other cognitive function disabilities and is one of the most challenging neurodegenerative disorders to treat because of its progressive nature. The disease affects millions of people all around the world, and the number of those affected is expanding every day. In the previous study, the 4-phthalimidobenzenesulfonamide derivatives were synthesized as AChE and BChE inhibitors, and here, we were aiming to further reporting in silico studies of these compounds for efficient drug discovery process and to find out the potential lead compounds. METHODS In silico characterization included density functional theory (DFT) studies, 3D-QSAR, ADMET properties, molecular docking, and molecular dynamic simulations. The geometries of all derivatives were optimized using B3LYP method and 6-311G basis set. RESULTS The findings of the current study revealed that 4-phthalimidobenzenesulfonamide derivatives exhibited a reactive electronic property which is essential for anticholinesterase activity. Moreover, optimized structures were subjected to molecular docking studies with targeted protein. The compounds 2c and 2g showed excellent binding score of -37.44 and -33.67 kJ/mol with BChE and AChE, respectively, and exhibited strong binding affinity. The potent derivatives produced stable complex with amino acid residues of active pocket of both BChE and AChE. The stability of protein-ligand complexes was determined by molecular dynamic simulation studies, and results were found in correlation with molecular docking findings. CONCLUSION Findings of the current study suggested that these derivatives are potent inhibitors of cholinesterase enzyme.
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Affiliation(s)
- Syeda Abida Ejaz
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Ammara Fayyaz
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Hafiz Mohammad Kashif Mahmood
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Mubashir Aziz
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Syeda Rabia Ejaz
- Department of Physics, The Government Sadiq College Women University, Bahawalpur, Pakistan
| | - Afrah Fahad Alkhuriji
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Wafa Abdullah I Al-Megrin
- Department of Biology, College of Science, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt
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Mattingly TJ, Diaz Fernandez V, Seo D, Melgar Castillo AI. A review of caregiver costs included in cost-of-illness studies. Expert Rev Pharmacoecon Outcomes Res 2022; 22:1051-1060. [PMID: 35607780 DOI: 10.1080/14737167.2022.2080056] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Economic evaluations typically focus solely on patient-specific costs with economic spillovers to informal caregivers less frequently evaluated. This may systematically underestimate the burden resulting from disease. AREAS COVERED Cost-of-illness (COI) analyses that identified costs borne to caregiver(s) were identified using PubMed and Embase. We extracted study characteristics, clinical condition, costs, and cost methods. To compare caregiver costs reported across studies, estimated a single 'annual caregiver cost' amount in 2021 USD. EXPERT OPINION A total of 51 studies met our search criteria for inclusion with estimates ranging from $30 - $86,543. The majority (63%, 32/51) of studies estimated caregiver time costs with fewer studies reporting productivity or other types of costs. Caregiver costs were frequently reported descriptively (69%, 35/51), with fewer studies reporting more rigorous methods of estimating costs. Only 27% (14/51) of studies included used an incremental analysis approach for caregiver costs. In a subgroup analysis of dementia-focused studies (n = 16), we found the average annual cost of caregiving time for patients with dementia was $30,562, ranging from $4,914 to $86,543. We identified a wide range in annual caregiver cost estimates, even when limiting by condition and cost type.
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Affiliation(s)
- T Joseph Mattingly
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA.,The PATIENTS Program, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Valeria Diaz Fernandez
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Dominique Seo
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Andrea I Melgar Castillo
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA.,The PATIENTS Program, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
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Engel L, Ajdukovic M, Bucholc J, McCaffrey N. Valuation of Informal Care Provided to People Living With Dementia: A Systematic Literature Review. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1863-1870. [PMID: 34838285 DOI: 10.1016/j.jval.2021.04.1283] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/22/2021] [Accepted: 04/21/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES This study aimed to identify the methods used to determine the value of informal care provided to people living with dementia and to estimate the average hourly unit cost by valuation method. METHODS A literature search in MEDLINE Complete, CINAHL, PsycINFO, EconLit, EMBASE and NHS Economic Evaluation Database was undertaken. Following the screening of title, abstract, and full text, characteristics of eligible studies were extracted systematically and analyzed descriptively. The corresponding hourly cost estimates were converted into 2018 US dollars based on purchasing power parities for gross domestic product. RESULTS A total number of 111 articles were included in this review from 3106 post-deduplication records. Three main valuation methodologies were identified: the replacement cost method (n = 50), the opportunity cost approach (n = 36), and the stated preference method based on willingness to pay (n = 3), with 16 studies using multiple methods and 6 studies not specifying the valuation method. The amount of informal care increased as the condition of dementia progressed, which was reflected in the cost of informal care. The average hourly unit cost used to value informal care was US $16.78 (SD = US $12.11). Although the unit cost was approximately US $15 per hour when using the opportunity cost method and US $14 when using the stated preference method, the highest unit cost was obtained when using the replacement cost method (US $18.37, SD = US $13.12). CONCLUSIONS Although costs of informal care should be considered when undertaking an economic evaluation or estimating the overall costs of dementia from a policy and priority-setting perspective, further research into applying consistent approaches to valuation is warranted.
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Affiliation(s)
- Lidia Engel
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia.
| | - Maja Ajdukovic
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Jessica Bucholc
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Nikki McCaffrey
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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Ma WJ, He B, Wang YH, Huang W, Zhou J. Relationships between Kazakh elders' disability severity and informal care time in far north-western low-income areas in China: The mediating roles of caregiver health and home-based care quality. Int J Nurs Pract 2021; 28:e13022. [PMID: 34687110 DOI: 10.1111/ijn.13022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 07/02/2021] [Accepted: 09/24/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Elders' disability severity and caregiver health could predict elders' informal care time, but the mechanism by which the degree of disability in the elderly affects informal care time is unclear. AIM The aim of this works is to explore the mediating roles of caregiver health and home-based care quality between disability severity of elders and informal care time in far north-western low-income areas in China. METHOD From September 2017 to February 2018, three hundred fifty-two dyads of Kazakh disabled elders and informal caregivers in Xinjiang were interviewed. Structural equation modelling analyses were applied. RESULTS Significant positive correlations were observed between elders' disability severity and informal care time, caregiver health and informal care time, elders' disability severity and caregiver health. Significant negative correlations were observed between home-based care quality and informal care time, elders' disability severity and home-based care quality, caregiver health and home-based care quality. Elders' disability severity had 71.94% direct effect on informal care time, 28.06% indirect effect on informal care time mediated by home-based care quality and caregiver health. CONCLUSION Caregiver health and home-based care quality play mediating roles on the path relationship between the elders' disability severity and informal care time.
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Affiliation(s)
- Wen Juan Ma
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.,West China College of Nursing, Sichuan University, Chengdu, China
| | - Bin He
- Department of joint surgery, The People's Hospital of Shihezi City, Shihezi, Xinjiang, China
| | - Yu Huan Wang
- Department of Medical Humanities, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Wei Huang
- Department of Medical Humanities, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Jia Zhou
- Department of Medical Humanities, Shihezi University School of Medicine, Shihezi, Xinjiang, China
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Ibuka Y, Ohtsu Y. Socioeconomic status and the likelihood of informal care provision in Japan: An analysis considering survival probability of care recipients. PLoS One 2021; 16:e0256107. [PMID: 34388176 PMCID: PMC8362941 DOI: 10.1371/journal.pone.0256107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 08/02/2021] [Indexed: 11/19/2022] Open
Abstract
Studies show that the burden of caregiving tends to fall on individuals of low socioeconomic status (SES); however, the association between SES and the likelihood of caregiving has not yet been established. We studied the relationship between SES and the likelihood of adults providing long-term care for their parents in Japan, where compulsory public long-term insurance has been implemented. We used the following six comprehensive measures of SES for the analysis: income, financial assets, expenditure, living conditions, housing conditions, and education. We found that for some SES measures the probability of care provision for parents was greater in higher SES categories than in the lowest category, although the results were not systematically related to the order of SES categories or consistent across SES measures. The results did not change even after the difference in the probability of parents' survival according to SES was considered. Overall, we did not find evidence that individuals with lower SES were more likely to provide care to parents than higher-SES individuals. Although a negative association between SES and care burden has been repeatedly reported in terms of care intensity, the caregiving decision could be different in relation to SES. Further research is necessary to generalize the results.
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Affiliation(s)
- Yoko Ibuka
- Faculty of Economics, Keio University, Tokyo, Japan
- * E-mail:
| | - Yui Ohtsu
- Graduate School of Humanities and Social Sciences, Saitama University, Saitama, Japan
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Blasioli E, Hassini E. e-Health Technological Ecosystems: Advanced Solutions to Support Informal Caregivers and Vulnerable Populations During the COVID-19 Outbreak. Telemed J E Health 2021; 28:138-149. [PMID: 33887168 DOI: 10.1089/tmj.2020.0522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: This study highlights the importance of technological ecosystems in supporting informal caregivers and vulnerable populations in coping with the ongoing coronavirus disease 2019 (COVID-19) pandemic. Methods: This study integrates the available literature on internet of things (IoT) e-health ecosystem and informal care. Results: In the first part of this article, we describe the health consequences of quarantine and isolation and outline the potential role of informal care in containing the risk of spreading the infection and reducing the burden on the health care system. Then, we present an overview of the characteristics of emerging technological ecosystems in health care and how they can be adopted as a strategic option to achieve different goals: (1) support informal carers to help vulnerable populations during quarantine and isolation and facilitate the recovery process; (2) promote the adoption of e-health and telemedicine resources to reduce the well-documented burden experienced by caregivers; and (3) lessen the various forms of digital disadvantage among vulnerable individuals, who are at more risk to be digitally excluded. In the last part of this work, we introduce solutions to overcome potential challenges related to the development and adoption of advanced technological ecosystems and propose a reflection on the legacy of COVID-19 on telemedicine. Conclusions: Thanks to the disruptive potential of IoT for health and wellness promotion, technological ecosystems emerge as a valuable resource to support both informal carers and vulnerable populations. The main factors that represent a strategic advantage of a technological ecosystem are affordability, regulatory, and availability. A high degree of interconnection between all the stakeholders emerges as a key element for the provision of intergenerational care. The most important technical challenges of IoT e-health require to optimize privacy, security, and user-friendliness of IoT e-health.
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Affiliation(s)
- Emanuele Blasioli
- DeGroote School of Business, McMaster University, Hamilton, Ontario, Canada
| | - Elkafi Hassini
- DeGroote School of Business, McMaster University, Hamilton, Ontario, Canada
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Villarejo Galende A, Eimil Ortiz M, Llamas Velasco S, Llanero Luque M, López de Silanes de Miguel C, Prieto Jurczynska C. Report by the Spanish Foundation of the Brain on the social impact of Alzheimer disease and other types of dementia. NEUROLOGÍA (ENGLISH EDITION) 2021. [DOI: 10.1016/j.nrleng.2017.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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Ydstebø AE, Benth JŠ, Bergh S, Selbæk G, Vossius C. Informal and formal care among persons with dementia immediately before nursing home admission. BMC Geriatr 2020; 20:296. [PMID: 32811440 PMCID: PMC7436969 DOI: 10.1186/s12877-020-01703-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 08/12/2020] [Indexed: 11/14/2022] Open
Abstract
Background Dementia is a care intensive disease, especially in the later stages, implying in many cases a substantial carer burden. This study assesses the use of formal and informal care resources among persons with dementia during the last month before nursing home admission. It also describes main providers of informal care and assesses the extent of informal care rendered by the extended social network. Methods In this cross-sectional study, we collected data about persons with dementia that were newly admitted to a nursing home in Norway. Information about the amount of formal and informal care during the last 4 weeks preceding nursing home admission was collected from the primary caregivers. Clinical data were collected by examining the patients, while sociodemographic data was collected from the patients’ files. Results A total of 395 persons with dementia were included. The amount of informal care provided by the family caregiver was 141.9 h per month SD = 227.4. Co-resident patients received five times more informal care than non-co-residents. Informal care from the extended social network was provided to 212 patients (53.7%) with a mean of 5.6 (SD = 11.2) hours per month and represented 3.8% of the total informal care rendered to the patients. Formal care was provided to 52.7% of the patients with a mean of 18.0 (SD = 50.1) hours per month. Co-residency was significantly associated with more informal care, and the associations varied with respect to age, relation to the caregiver, and the caregiver’s working situation. Good/excellent general health was associated with less formal care. Conclusion Persons with dementia on the verge of admission to a nursing home are mainly supported by the family caregiver, and the use of informal care is particularly high among co-residents. In order to delay nursing home admission, future research should explore the unrealized care potential in extended social networks, as well as the potential for increasing the number of recipients of formal care services.
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Affiliation(s)
- Arnt Egil Ydstebø
- Centre for Age-related Medicine, Stavanger University Hospital, Stavanger, Norway. .,Centre for Development of Institutional and Home Care Services Rogaland, Stavanger, Norway. .,Research centre for Age-related Functional decline and Disease, Innlandet Hospital Trust, Postboks 68, N-2312, Ottestad, Norway.
| | - Jurate Šaltytė Benth
- Research centre for Age-related Functional decline and Disease, Innlandet Hospital Trust, Postboks 68, N-2312, Ottestad, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Health Services Research Unit, Akershus University Hospital, Akershus, Norway
| | - Sverre Bergh
- Research centre for Age-related Functional decline and Disease, Innlandet Hospital Trust, Postboks 68, N-2312, Ottestad, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Geir Selbæk
- Research centre for Age-related Functional decline and Disease, Innlandet Hospital Trust, Postboks 68, N-2312, Ottestad, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Corinna Vossius
- Centre for Age-related Medicine, Stavanger University Hospital, Stavanger, Norway.,Centre for Development of Institutional and Home Care Services Rogaland, Stavanger, Norway
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Liu W, Lyu T, Zhang X, Yuan S, Zhang H. Willingness-to-pay and willingness-to-accept of informal caregivers of dependent elderly people in Shanghai, China. BMC Health Serv Res 2020; 20:618. [PMID: 32631341 PMCID: PMC7339502 DOI: 10.1186/s12913-020-05481-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/28/2020] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND In order to make optimal long-term care-related decisions, it is important to take a societal perspective. Shanghai is one of the pilot cities of social long-term care insurance in China. However, little knowledge exists about the economic value of the informal care provided to dependent elderly people in China. This paper aims to evaluate the economic value of informal caregiving in Shanghai using the contingent valuation method by their least-preferred care tasks, and identify the associated factors of willingness-to-pay (WTP) and willingness-to-accept (WTA) of the informal caregivers. METHODS This study employed the contingent valuation method to elicit 371 informal caregivers' WTP and WTA for 1 hour of reduction or increase of least-preferred caring tasks in Shanghai. Univariate and multivariate analyses were conducted to explore the associated factors with the WTP and WTA values. RESULTS The average WTP and WTA were 25.31 CNY and 38.66 CNY, respectively. The associated factors with WTP include caregiver's income and caregiver's relationship to the recipient. Care recipient's age, income, least-preferred task by the caregiver, and subscales of Caregiver Reaction Assessment were found to be associated with WTA. The non-responsiveness rates were 26.1 and 33.2% for WTP and WTA questions, respectively. CONCLUSIONS The findings of the current study demonstrated that decision-makers and researchers should take the economic valuation results of informal care into account to make more informed and effective long-term care-related policies and analyses.
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Affiliation(s)
- Wenwei Liu
- College of Philosophy, Law and Political Science, Shanghai Normal University, Shanghai, China.,School of International and Public Affairs, Shanghai Jiao Tong University, Xin Jian Building, 1954 Huashan Rd, Shanghai, 200030, China
| | - Tongzhou Lyu
- College of Philosophy, Law and Political Science, Shanghai Normal University, Shanghai, China
| | - Xiaoyi Zhang
- School of International and Public Affairs, Shanghai Jiao Tong University, Xin Jian Building, 1954 Huashan Rd, Shanghai, 200030, China
| | - Suwei Yuan
- China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Huimin Zhang
- School of International and Public Affairs, Shanghai Jiao Tong University, Xin Jian Building, 1954 Huashan Rd, Shanghai, 200030, China.
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15
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Del Pozo-Rubio R, Moya-Martínez P, Ortega-Ortega M, Oliva-Moreno J. Shadow and extended shadow cost sharing associated to informal long-term care: the case of Spain. HEALTH ECONOMICS REVIEW 2020; 10:12. [PMID: 32430791 PMCID: PMC7236927 DOI: 10.1186/s13561-020-00272-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 05/08/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND A large part of the long-term care is provided by non-professional caregivers, generally without any monetary payment but a value economic of time invested. The economic relevance of informal caregivers has been recognized in Spain; however, public provision may still be scarce. The objective of this paper is to estimate the economic burden associated with informal long-term care that should assume the families through a new concept of cost sharing that consider opportunity costs of time provided by informal caregivers. METHODS The study sample includes all dependent adults in Spain. Socioeconomic information and the number of hours of informal care was collected through the Spanish Disability and Dependency Survey. The terms of shadow and extended shadow cost sharing were defined as the difference between the maximum potential amount of money that families could receive for the provision of informal care and the amount that actually they received and the value of informal care time with respect to the amount received, respectively. RESULTS 53.87% of dependent persons received an economic benefit associated to informal care. The average weekly hours of care were 71.59 (92.62 without time restrictions). Shadow cost sharing amounted to, on average, two thirds, whereas the State financed the remaining third. In terms of extended shadow cost sharing, the State financed between 3% and 10% of informal care provided by caregivers. CONCLUSIONS This study reveals the deficient support received for the provision of informal care in Spain. More than 90% of informal care time is not covered by the economic benefits that families receive from the State.
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Affiliation(s)
- Raúl Del Pozo-Rubio
- Department of Economics and Finance, University of Castilla-La Mancha, Avda, Los Alfares, 44 16.071, Cuenca, Spain
| | - Pablo Moya-Martínez
- Department of Economics and Finance, University of Castilla-La Mancha, Avda, Los Alfares, 44 16.071, Cuenca, Spain
| | - Marta Ortega-Ortega
- Department of Applied Economics, Public Economics and Political Economy, Complutense University of Madrid, Campus de Somosaguas s/n. 28.223 Pozuelo de Alarcón, Madrid, Spain
| | - Juan Oliva-Moreno
- Department of Economics and Finance, University of Castilla-La Mancha, Calle San Pedro Mártir, 7, 45002 Toledo, Spain
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Maresova P, Lee S, Fadeyi OO, Kuca K. The social and economic burden on family caregivers for older adults in the Czech Republic. BMC Geriatr 2020; 20:171. [PMID: 32393190 PMCID: PMC7216393 DOI: 10.1186/s12877-020-01571-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 04/27/2020] [Indexed: 12/05/2022] Open
Abstract
Background In this paper, we analyse the economic burden of elder care in the Czech Republic by assessing how family members of senior citizens engage in caregiving. To do this, we examined the time and cost associated with caregiving as a function of age, gender, and income of the caregiver. Methods A questionnaire comprising 17 items was used to gather data from 155 informal caregivers whose seniors are affiliated with 200 registered home care agencies. Spearman rank correlation was adopted to analyse how caregivers’ income, age and gender influences the costs accrued and time spent in caring for elders. The expenses are divided into direct and indirect. Publicly available sources are used to establish expenses on treatment and medication, which cannot be determined by the questionnaire survey. Results Results show that around-the-clock care is the most common. Spouses of care recipients make up the highest number of caregivers, and women represent the largest portion of this group. Additionally, the more the time spent caring for an elder, the higher the cost associated with such care. The total annual burden of informal caregivers is determined by the sum of annual average indirect costs, amounting to € 36,888, and annual direct costs, amounting to € 2775, resulting in a total of € 39,663 per year. Conclusion Czech social policymakers should begin to consider better packages for caregivers in the form of incentives and other monetary benefits to improve living standards and care for ageing seniors.
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Affiliation(s)
- Petra Maresova
- Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, 50003, Hradec Kralove, Czech Republic
| | - Sunwoo Lee
- Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, 50003, Hradec Kralove, Czech Republic
| | - Oluwaseun Omolaja Fadeyi
- Department of Geology, Faculty of Geography and Geoscience, University of Trier, Universitätsring 15, 54296, Trier, Germany
| | - Kamil Kuca
- Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, 50003, Hradec Kralove, Czech Republic.
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Myocardial infarction: Economic, health, and social impacts on informal caregivers. Int J Technol Assess Health Care 2020; 36:245-251. [PMID: 32312345 DOI: 10.1017/s0266462320000148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The aim of the study was to measure the economic impact of informal care (IC) on caregivers assisting myocardial infarction (MI) survivors in France. Health and social impacts were also described. METHODS Data from the prospective 2008 Health and Disabilities Households Survey (Enquête Handicap-Santé), carried out among the French general population, were used to obtain information about patients with MI and their informal caregivers. To estimate the approximate monetary value of IC, three methods were used: the proxy good method, opportunity cost method (OCM), and contingent valuation method (CVM). A multivariate analysis was performed to determine the associations of the IC duration and the existence of professional care with the health indicators stated by caregivers. RESULTS The analysis included data from 147 caregivers. The mean value of IC ranged from €9,679 per year using the CVM to €11,288 per year using the OCM (p > .05). The mean willingness to pay for an additional hour of IC was €10.9 (SD = 8.3). A total of 46.2 percent of caregivers reported that IC negatively affected theirs physical condition, and 46.3 percent reported that it negatively affected their psychological health. In addition, 40.1 percent declared that caregiving activity made them anxious and 38.8 percent stated they felt alone. Associations were identified between the duration of IC and feeling the need to be replaced, feeling alone and making sacrifices (p < .05). CONCLUSIONS Informal caregiver burden may be recognized in health technology assessment in order not to underestimate the cost of strategies and to facilitate the comparability of cost-effectiveness outcomes between studies.
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Financial Catastrophism Inherent with Out-of-Pocket Payments in Long Term Care for Households: A Latent Impoverishment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17010295. [PMID: 31906289 PMCID: PMC6981754 DOI: 10.3390/ijerph17010295] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 12/21/2019] [Accepted: 12/29/2019] [Indexed: 11/17/2022]
Abstract
Background: Out-of-pocket (OOP) payments are configured as an important source of financing long-term care (LTC). However, very few studies have analyzed the risk of impoverishment and catastrophic effects of OOP in LTC. To estimate the contribution of users to the financing of LTC and to analyze the economic consequences for households in terms of impoverishment and catastrophism after financial crisis in Spain. METHODS The database that was used is the 2008 Spanish Disability and Dependency Survey, projected to 2012. We analyze the OOP payments effect associated to the impoverishment of households comparing volume and financial situation before and after OOP payment. At the same time, the extent to which OOP payment had led to catastrophism was analyzed using different thresholds. RESULTS The results show that contribution of dependent people to the financing of the services they receive exceeds by 50% the costs of these services. This expenditure entails an increase in the number of households that live below the poverty. In terms of catastrophism, more than 80% of households dedicate more than 10% of their income to dependency OOP payments. In annual terms, the catastrophe gap generated by devoting more than 10% of the household income to dependent care OOP payment reached €3955, 1 million (0.38% of GDP). CONCLUSION This article informs about consequences of OOP in LCT and supplements previous research that focus on health. Our results should serve to develop strategic for protection against the financial risk resulting from facing the costs of a situation of dependence.
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Costs and Burden Associated With Loss of Labor Productivity in Informal Caregivers of People With Dementia: Results From Spain. J Occup Environ Med 2019; 60:449-456. [PMID: 29135840 DOI: 10.1097/jom.0000000000001229] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS We analyzed indirect costs related to loss of labor productivity (LLP) in informal caregivers (ICs) of people with dementia (PwD) and the associated caregiver burden and patients' clinical variables. METHODS Multicenter cohort study of PwD and their ICs (n = 287) focused on two groups: (1) home care and (2) institutional long-term care. The costs of LLP were assessed using the Resource Utilization Dementia instrument and a human capital approach. RESULTS The cost for LLP was 378&OV0556;/month or 4.536&OV0556;/year. Greater disease severity increased the likelihood of reducing working hours and missing a working day. There was a significant association between partial absenteeism and burden in employed informal caregiver in both the home and institutional setting. CONCLUSION Cognitive impairment contributes to the cost of LLP in IC especially in home-care. LLP has a negative impact on IC burden.
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20
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Nakabe T, Sasaki N, Uematsu H, Kunisawa S, Wimo A, Imanaka Y. Classification tree model of the personal economic burden of dementia care by related factors of both people with dementia and caregivers in Japan: a cross-sectional online survey. BMJ Open 2019; 9:e026733. [PMID: 31289069 PMCID: PMC6629423 DOI: 10.1136/bmjopen-2018-026733] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 06/12/2019] [Accepted: 06/13/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The purpose of this study was to clarify the microlevel determinants of the economic burden of dementia care at home in Japanese community settings by classifying them into subgroups of factors related to people with dementia and their caregivers. DESIGN A cross-sectional online survey. PARTICIPANTS 4313 panels of Japanese research company who fulfilled the following criteria: (1) aged 30 years or older, (2) non-professional caregiver of someone with dementia, (3) caring for only one person with dementia and (4) having no conflicts of interest with advertising or marketing research entities. PRIMARY OUTCOME MEASURES Informal care costs and out-of-pocket payments for long-term care (LTC) services. RESULTS From 4313 respondents, only 1383 caregivers in community-settings were included in this analysis. We conducted a χ² automatic interaction detection analysis to identify the factors related to each cost (informal care costs and out-of-pocket payments for LTC services) divided into subcategories. In the resultant classifications, informal care cost was mainly related to caregivers' employment status. When caregivers acquired family care leave, informal care costs were the highest. On the other hand, out-of-pocket payments for LTC were related to care-need levels and family economic status. Activities of Daily Living and Instrumental Activities of Daily Living functions such as bathing, toileting and cleaning were related to all costs. CONCLUSION This study clarified the difference in dementia care costs between classified subgroups by considering the combination of the situations of both people with dementia and their caregivers. Informal care costs were related to caregivers' employment and cohabitation status rather to the situations of people with dementia. On the other hand, out-of-pocket payments for LTC services were related to care-need levels and family economic status. These classifications will be useful in understanding which situation represents a greater economic burden and helpful in improving the sustainability of the dementia care system in Japan.
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Affiliation(s)
- Takayo Nakabe
- Department of Healthcare Economics and Quality Management, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Noriko Sasaki
- Department of Healthcare Economics and Quality Management, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hironori Uematsu
- Department of Healthcare Economics and Quality Management, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Susumu Kunisawa
- Department of Healthcare Economics and Quality Management, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Anders Wimo
- KI Alzheimer's Disease Research Center (ADRC), Karolinska Institute, Karolinska, Sweden
| | - Yuichi Imanaka
- Department of Healthcare Economics and Quality Management, Kyoto University Graduate School of Medicine, Kyoto, Japan
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21
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Oliva-Moreno J, Peña-Longobardo LM, García-Mochón L, del Río Lozano M, Mosquera Metcalfe I, García-Calvente MDM. The economic value of time of informal care and its determinants (The CUIDARSE Study). PLoS One 2019; 14:e0217016. [PMID: 31112587 PMCID: PMC6529156 DOI: 10.1371/journal.pone.0217016] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 05/02/2019] [Indexed: 11/19/2022] Open
Abstract
Objective The main aims of this paper are to analyse the monetary value of informal care time using different techniques and to identify significant variables associated with the number of caregiving hours. Data and methods A multicentre study in two Spanish regions in adult caregivers was conducted. A total sample of 604 people was available. A multivariate analysis was performed to identify the variables associated with the number of hours of caregiving time. In the monetary valuation of informal care provided, three approaches were used: replacement cost method, opportunity cost and contingent valuation (willingness to pay and willingness to accept). Results The main determinants of the amount of time of informal care provided were age, gender, the level of care receiver´s dependence and the professional care services received (at home and out of home). The value estimated for informal care time ranges from EUROS 80,247 (replacement cost method) to EUROS 14,325 (willingness to pay), with intermediate values of EUROS 27,140 and EUROS 29,343 (opportunity cost and willingness to accept, respectively). Several sensitivity analyses were performed over the base cases, confirming the previous results. Conclusions Time of informal care represents a great social value, regardless of the applied technique. However, the results can differ strongly depending on the technique chosen. Therefore, the choice of technique of valuation is not neutral. Among the determinants of informal care time, the professional care received at home has a complementary character to informal care, while the formal care outside the home has a substitute character.
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Affiliation(s)
- Juan Oliva-Moreno
- University of Castilla-La Mancha, Department of Economic Analysis and Seminar of Research on Economics and Health (SIES), Toledo, Spain
| | - Luz María Peña-Longobardo
- University of Castilla-La Mancha, Department of Economic Analysis and Seminar of Research on Economics and Health (SIES), Toledo, Spain
- * E-mail:
| | - Leticia García-Mochón
- Andalusian School of Public Health (EASP), Granada, Spain
- Biomedical Research Centre (ibs.GRANADA), Granada, Spain
| | - María del Río Lozano
- Andalusian School of Public Health (EASP), Granada, Spain
- Biomedical Research Centre (ibs.GRANADA), Granada, Spain
| | - Isabel Mosquera Metcalfe
- University of Basque Country, Department of Sociology and Research Group on social determinants of health and demographic change (OPIK), Gipuzkoa, Spain
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Grosse SD, Pike J, Soelaeman R, Tilford JM. Quantifying Family Spillover Effects in Economic Evaluations: Measurement and Valuation of Informal Care Time. PHARMACOECONOMICS 2019; 37:461-473. [PMID: 30953263 PMCID: PMC6529092 DOI: 10.1007/s40273-019-00782-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Spillover effects on the welfare of family members may refer to caregiver health effects, informal care time costs, or both. This review focuses on methods that have been used to measure and value informal care time and makes suggestions for their appropriate use in cost-of-illness and cost-effectiveness analyses. It highlights the importance of methods to value informal care time that are independent of caregiver health effects in order to minimize double counting of spillover effects. Although the concept of including caregiver time costs in economic evaluations is not new, relatively few societal perspective cost-effectiveness analyses have included informal care, with the exception of dementia. This is due in part to challenges in measuring and valuing time costs. Analysts can collect information on time spent in informal care or can assess its impact in displacing other time use, notably time in paid employment. A key challenge is to ensure appropriate comparison groups that do not require informal care to be able to correctly estimate attributable informal care time or foregone market work. To value informal care time, analysts can use estimates of hourly earnings in either opportunity cost or replacement cost approaches. Researchers have used widely varying estimates of hourly earnings. Alternatively, stated-preference methods (i.e. contingent valuation, conjoint analysis) can be used to value the effect of informal care on utility, but this can entail double counting with health effects. Lack of consensus and standardization of methods makes it difficult to compare estimates of informal care costs.
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Affiliation(s)
- Scott D Grosse
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS E-87, Atlanta, GA, 30341, USA.
| | - Jamison Pike
- Immunization Services Division, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rieza Soelaeman
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS E-87, Atlanta, GA, 30341, USA
| | - J Mick Tilford
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Nakabe T, Sasaki N, Uematsu H, Kunisawa S, Wimo A, Imanaka Y. The personal cost of dementia care in Japan: A comparative analysis of residence types. Int J Geriatr Psychiatry 2018; 33:1243-1252. [PMID: 29892984 DOI: 10.1002/gps.4916] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 04/13/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVE We aimed to quantify the personal economic burden of dementia care in Japan according to residence type. METHODS A cross-sectional online survey was conducted on 3841 caregivers of people with dementia. An opportunity cost approach was used to calculate informal care costs. All costs and the observed/expected (OE) ratio of costs were adjusted using patient sex, age, and care-needs levels, and compared among the residence types. RESULTS The mean daily informal care time was 8.2 hours, and the mean monthly informal care costs for community-dwelling people with dementia were US$1559. The OE ratio for informal care costs in community-dwelling patients was higher than in institutionalized patients. CONCLUSION The inclusion of informal care costs reduced the differences in total personal costs among the residence types. The economic burden of informal care should be considered when quantifying dementia care costs.
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Affiliation(s)
- Takayo Nakabe
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan
| | - Noriko Sasaki
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan
| | - Hironori Uematsu
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan
| | - Susumu Kunisawa
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan
| | - Anders Wimo
- Aging Research Centre, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Yuichi Imanaka
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan
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Oliva-Moreno J, Peña-Longobardo LM, Mar J, Masjuan J, Soulard S, Gonzalez-Rojas N, Becerra V, Casado MÁ, Torres C, Yebenes M, Quintana M, Alvarez-Sabín J. Determinants of Informal Care, Burden, and Risk of Burnout in Caregivers of Stroke Survivors. Stroke 2018; 49:140-146. [DOI: 10.1161/strokeaha.117.017575] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 10/19/2017] [Accepted: 10/23/2017] [Indexed: 12/26/2022]
Abstract
Background and Purpose—
The aim of this article was to analyze the likelihood of receiving informal care after a stroke and to study the burden and risk of burnout of primary caregivers in Spain.
Methods—
The CONOCES study is an epidemiological, observational, prospective, multicenter study of patients diagnosed with stroke and admitted to a Stroke Unit in the Spanish healthcare system. At 3 and 12 months post-event, we estimated the time spent caring for the patient and the burden borne by primary caregivers. Several multivariate models were applied to estimate the likelihood of receiving informal caregiving, the burden, and the likelihood of caregivers being at a high risk of burnout.
Results—
Eighty percent of those still alive at 3 and 12 months poststroke were receiving informal care. More than 40% of those receiving care needed a secondary caregiver at 3 months poststroke. The likelihood of receiving informal care was associated with stroke severity and the individual’s health-related quality of life. When informal care was provided, both the burden borne by caregivers and the likelihood of caregivers being at a high risk of burnout was associated with (1) caregiving hours; (2) the patient’s health-related quality of life; (3) the severity of the stroke measured at discharge; (4) the patient having atrial fibrillation; and (5) the degree of dependence.
Conclusions—
This study reveals the heavy burden borne by the caregivers of stroke survivors. Our analysis also identifies explanatory and predictive variables for the likelihood of receiving informal care, caregiver burden, and high risk of burnout.
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Affiliation(s)
- Juan Oliva-Moreno
- From the Department of Economic Analysis, Universidad de Castilla-La Mancha, Toledo, Spain (J.O.-M., L.M.P.-L.); Clinical Management Service, Alto Deba Hospital, Mondragon, Spain (J. Mar); Stroke Unit, Neurology Department, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain (J. Masjuan); Health Economics and Outcomes Research, Boehringer Ingelheim España, Barcelona, Spain (S.S., N.G.-R., V.B.); Pharmacoeconomics and Outcomes Research Iberia, Madrid, Spain (M.Á.C., C.T., M.Y
| | - Luz María Peña-Longobardo
- From the Department of Economic Analysis, Universidad de Castilla-La Mancha, Toledo, Spain (J.O.-M., L.M.P.-L.); Clinical Management Service, Alto Deba Hospital, Mondragon, Spain (J. Mar); Stroke Unit, Neurology Department, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain (J. Masjuan); Health Economics and Outcomes Research, Boehringer Ingelheim España, Barcelona, Spain (S.S., N.G.-R., V.B.); Pharmacoeconomics and Outcomes Research Iberia, Madrid, Spain (M.Á.C., C.T., M.Y
| | - Javier Mar
- From the Department of Economic Analysis, Universidad de Castilla-La Mancha, Toledo, Spain (J.O.-M., L.M.P.-L.); Clinical Management Service, Alto Deba Hospital, Mondragon, Spain (J. Mar); Stroke Unit, Neurology Department, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain (J. Masjuan); Health Economics and Outcomes Research, Boehringer Ingelheim España, Barcelona, Spain (S.S., N.G.-R., V.B.); Pharmacoeconomics and Outcomes Research Iberia, Madrid, Spain (M.Á.C., C.T., M.Y
| | - Jaime Masjuan
- From the Department of Economic Analysis, Universidad de Castilla-La Mancha, Toledo, Spain (J.O.-M., L.M.P.-L.); Clinical Management Service, Alto Deba Hospital, Mondragon, Spain (J. Mar); Stroke Unit, Neurology Department, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain (J. Masjuan); Health Economics and Outcomes Research, Boehringer Ingelheim España, Barcelona, Spain (S.S., N.G.-R., V.B.); Pharmacoeconomics and Outcomes Research Iberia, Madrid, Spain (M.Á.C., C.T., M.Y
| | - Stéphane Soulard
- From the Department of Economic Analysis, Universidad de Castilla-La Mancha, Toledo, Spain (J.O.-M., L.M.P.-L.); Clinical Management Service, Alto Deba Hospital, Mondragon, Spain (J. Mar); Stroke Unit, Neurology Department, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain (J. Masjuan); Health Economics and Outcomes Research, Boehringer Ingelheim España, Barcelona, Spain (S.S., N.G.-R., V.B.); Pharmacoeconomics and Outcomes Research Iberia, Madrid, Spain (M.Á.C., C.T., M.Y
| | - Nuria Gonzalez-Rojas
- From the Department of Economic Analysis, Universidad de Castilla-La Mancha, Toledo, Spain (J.O.-M., L.M.P.-L.); Clinical Management Service, Alto Deba Hospital, Mondragon, Spain (J. Mar); Stroke Unit, Neurology Department, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain (J. Masjuan); Health Economics and Outcomes Research, Boehringer Ingelheim España, Barcelona, Spain (S.S., N.G.-R., V.B.); Pharmacoeconomics and Outcomes Research Iberia, Madrid, Spain (M.Á.C., C.T., M.Y
| | - Virginia Becerra
- From the Department of Economic Analysis, Universidad de Castilla-La Mancha, Toledo, Spain (J.O.-M., L.M.P.-L.); Clinical Management Service, Alto Deba Hospital, Mondragon, Spain (J. Mar); Stroke Unit, Neurology Department, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain (J. Masjuan); Health Economics and Outcomes Research, Boehringer Ingelheim España, Barcelona, Spain (S.S., N.G.-R., V.B.); Pharmacoeconomics and Outcomes Research Iberia, Madrid, Spain (M.Á.C., C.T., M.Y
| | - Miguel Ángel Casado
- From the Department of Economic Analysis, Universidad de Castilla-La Mancha, Toledo, Spain (J.O.-M., L.M.P.-L.); Clinical Management Service, Alto Deba Hospital, Mondragon, Spain (J. Mar); Stroke Unit, Neurology Department, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain (J. Masjuan); Health Economics and Outcomes Research, Boehringer Ingelheim España, Barcelona, Spain (S.S., N.G.-R., V.B.); Pharmacoeconomics and Outcomes Research Iberia, Madrid, Spain (M.Á.C., C.T., M.Y
| | - Covadonga Torres
- From the Department of Economic Analysis, Universidad de Castilla-La Mancha, Toledo, Spain (J.O.-M., L.M.P.-L.); Clinical Management Service, Alto Deba Hospital, Mondragon, Spain (J. Mar); Stroke Unit, Neurology Department, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain (J. Masjuan); Health Economics and Outcomes Research, Boehringer Ingelheim España, Barcelona, Spain (S.S., N.G.-R., V.B.); Pharmacoeconomics and Outcomes Research Iberia, Madrid, Spain (M.Á.C., C.T., M.Y
| | - María Yebenes
- From the Department of Economic Analysis, Universidad de Castilla-La Mancha, Toledo, Spain (J.O.-M., L.M.P.-L.); Clinical Management Service, Alto Deba Hospital, Mondragon, Spain (J. Mar); Stroke Unit, Neurology Department, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain (J. Masjuan); Health Economics and Outcomes Research, Boehringer Ingelheim España, Barcelona, Spain (S.S., N.G.-R., V.B.); Pharmacoeconomics and Outcomes Research Iberia, Madrid, Spain (M.Á.C., C.T., M.Y
| | - Manuel Quintana
- From the Department of Economic Analysis, Universidad de Castilla-La Mancha, Toledo, Spain (J.O.-M., L.M.P.-L.); Clinical Management Service, Alto Deba Hospital, Mondragon, Spain (J. Mar); Stroke Unit, Neurology Department, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain (J. Masjuan); Health Economics and Outcomes Research, Boehringer Ingelheim España, Barcelona, Spain (S.S., N.G.-R., V.B.); Pharmacoeconomics and Outcomes Research Iberia, Madrid, Spain (M.Á.C., C.T., M.Y
| | - Jose Alvarez-Sabín
- From the Department of Economic Analysis, Universidad de Castilla-La Mancha, Toledo, Spain (J.O.-M., L.M.P.-L.); Clinical Management Service, Alto Deba Hospital, Mondragon, Spain (J. Mar); Stroke Unit, Neurology Department, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain (J. Masjuan); Health Economics and Outcomes Research, Boehringer Ingelheim España, Barcelona, Spain (S.S., N.G.-R., V.B.); Pharmacoeconomics and Outcomes Research Iberia, Madrid, Spain (M.Á.C., C.T., M.Y
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Report by the Spanish Foundation of the Brain on the social impact of Alzheimer disease and other types of dementia. Neurologia 2017; 36:39-49. [PMID: 29249303 DOI: 10.1016/j.nrl.2017.10.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 10/10/2017] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Knowledge of the socioeconomic impact of dementia-related disorders is essential for appropriate management of healthcare resources and for raising social awareness. METHODS We performed a literature review of the published evidence on the epidemiology, morbidity, mortality, associated disability and dependence, and economic impact of dementia and Alzheimer disease (AD) in Spain. CONCLUSIONS Most population studies of patients older than 65 report prevalence rates ranging from 4% to 9%. Prevalence of dementia and AD is higher in women for nearly every age group. AD is the most common cause of dementia (50%-70% of all cases). Dementia is associated with increased morbidity, mortality, disability, and dependence, and results in a considerable decrease in quality of life and survival. Around 80% of all patients with dementia are cared for by their families, which cover a mean of 87% of the total economic cost, resulting in considerable economic and health burden on caregivers and loss of quality of life. The economic impact of dementia is huge and difficult to evaluate due to the combination of direct and indirect costs. More comprehensive programmes should be developed and resources dedicated to research, prevention, early diagnosis, multidimensional treatment, and multidisciplinary management of these patients in order to reduce the health, social, and economic burden of dementia.
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Ortega-Ortega M, Montero-Granados R, Jiménez-Aguilera JDD. Differences in the economic valuation and determining factors of informal care over time: the case of blood cancer. GACETA SANITARIA 2017; 32:411-417. [PMID: 28529098 DOI: 10.1016/j.gaceta.2017.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 01/26/2017] [Accepted: 02/06/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To estimate differences in the economic valuation and sociodemographic and clinical factors associated with informal care between phases of the treatment in the case of blood cancer patients. METHODS 139 haematological cancer patients who underwent a stem cell transplantation completed a longitudinal questionnaire according to 3 phases of the treatment: short-term (pre-transplant), medium-term (1st year post-transplant) and long-term (2nd-6th year post-transplant). Economic value of informal care was estimated using proxy good and opportunity cost methods. Ordered and binary logistic models were performed to identify factors associated with informal care. RESULTS 123 patients reported having received informal care. A progressive reduction of the number of hours of care was observed between phases. Monetary value per patient ranged from 1,288 to 3,409; 1,045 to 2,786; and 336 to 854 €/month in the short, medium and long term, respectively. Patients with acute leukaemia and those who received an unrelated allogeneic transplantation were 22% (short-term) and 33.5% (medium-term) more likely to receive more than 8hours/day of care respect to patients diagnosed with lymphoma and autologous transplantation. In the long term, patients with multiple myeloma were more likely to receive more care. Better health status and higher educational level were associated with fewer daily hours of care. CONCLUSIONS Informal care varies greatly between stages of the treatment depending on the clinical and sociodemographic factors. Significant caring time and societal costs are associated with such care in blood cancer patients.
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Affiliation(s)
- Marta Ortega-Ortega
- Applied Economic Department, School of Economic and Business, University of Granada, Granada, Spain.
| | - Roberto Montero-Granados
- Applied Economic Department, School of Economic and Business, University of Granada, Granada, Spain
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Oliva-Moreno J, Trapero-Bertran M, Peña-Longobardo LM, Del Pozo-Rubio R. The Valuation of Informal Care in Cost-of-Illness Studies: A Systematic Review. PHARMACOECONOMICS 2017; 35:331-345. [PMID: 27848219 DOI: 10.1007/s40273-016-0468-y] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BACKGROUND There is a growing interest in incorporating informal care in cost-of-illness studies as a relevant part of the economic impact of some diseases. OBJECTIVE The aim of this paper was to review the recent literature valuating the costs of informal care in a group of selected diseases from 2005 to 2015. METHODS We carried out a systematic review on the economic impact of informal care, focusing on six selected diseases: arthritis or osteoarthritis, cancer, dementia, mental diseases, multiple sclerosis and stroke. RESULTS We selected 91 cost-of-illness articles. The average weight attributed to the informal care cost over the total cost was highly relevant for dementia, stroke, mental diseases, cancer and multiple sclerosis. The most frequent valuation method applied was the opportunity cost method, followed by the proxy good method. The annual cost of informal care presented a high variability depending on the disease and geographic location. Distinguishing by type of illness, the disease with the highest annual value of informal caregiving was dementia, followed by mental illness and multiple sclerosis. The average hourly unit cost was €11.43 (2015 values), varying noticeably depending on the geographic location. CONCLUSION This paper identifies several aspects that should be enhanced to promote comparability between studies and countries, and it sends key messages for incorporating informal care costs to adequately measure the economic impact of diseases.
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Affiliation(s)
- Juan Oliva-Moreno
- Department of Economic Analysis and Finance, Faculty of Law and Social Sciences, Universidad de Castilla La-Mancha, Toledo, Spain.
| | - Marta Trapero-Bertran
- Faculty of Economics and Social Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Luz Maria Peña-Longobardo
- Department of Economic Analysis and Finance, Faculty of Law and Social Sciences, Universidad de Castilla La-Mancha, Toledo, Spain
| | - Raúl Del Pozo-Rubio
- Department of Economic Analysis and Finance, Faculty of Social Sciences, Universidad de Castilla La-Mancha, Cuenca, Spain
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Del Pozo-Rubio R, Pardo-García I, Escribano-Sotos F. [The co-payment of the dependence from the structural reform of 2012 in Spain]. GACETA SANITARIA 2016; 31:23-29. [PMID: 27856017 DOI: 10.1016/j.gaceta.2016.09.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 09/12/2016] [Accepted: 09/19/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The objective of this piece of work is to establish the cost of dependency and the cost of financing it. Specifically, we will determine the cost of co-payment for individual users following the modification introduced by the 13th of July 2012 Resolution as well as its allocation by the autonomous regions. METHODS The degree and level of dependency was established using the Survey on Disability, Personal Autonomy and Dependency Situations, 2008. The cost of dependency according to degree and level and autonomous regions was established with information from the System for Personal Autonomy and Care of Dependent Persons. The co-payment was established according to applicants' purchasing power. The rating of these services, and the contribution of individual users were done in agreement with 2012 legislation and with common indicators and benchmarks for the whole national territory. RESULTS The total estimated cost is 10,598.8 million euros (1.03% of GDP), and Andalusia, the Valencian Community and Catalonia are those regions with the greatest costs. The average national co-payment per individual user is 53.54%, with differences due to degrees and levels of disability and autonomous regions, although, generally speaking, all of the users fund more than half of the care they receive. CONCLUSIONS This change in legislation has meant that co-payment is higher than the 33% established by this law and that co-payments prior to 2012 were about 20%. If we add to this the differences in autonomous regions, it would be useful to reflect on the uneven application of the law.
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Affiliation(s)
- Raúl Del Pozo-Rubio
- Facultad de Ciencias Sociales, Centro de Estudios Sociosanitarios, Universidad de Castilla-La Mancha, Cuenca, España
| | - Isabel Pardo-García
- Facultad de Ciencias Económicas y Empresariales, Centro de Estudios Sociosanitarios, Universidad de Castilla-La Mancha, Albacete, España.
| | - Francisco Escribano-Sotos
- Facultad de Ciencias Económicas y Empresariales, Centro de Estudios Sociosanitarios, Universidad de Castilla-La Mancha, Albacete, España
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Hu S, Yu X, Chen S, Clay E, Toumi M, Milea D. Memantine for treatment of moderate or severe Alzheimer’s disease patients in urban China: clinical and economic outcomes from a health economic model. Expert Rev Pharmacoecon Outcomes Res 2015; 15:565-78. [DOI: 10.1586/14737167.2015.1065734] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Oliva-Moreno J, Peña-Longobardo LM, Vilaplana-Prieto C. An estimation of the value of informal care provided to dependent people in Spain. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2015; 13:223-231. [PMID: 25761544 DOI: 10.1007/s40258-015-0161-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND AND OBJECTIVE The aim of this paper was to arrive at an approximation of the value of non-professional (informal) care provided to disabled people living within a household in Spain. METHODS We used the Survey on Disabilities, Autonomy and Dependency carried out in 2008 to obtain information about disabled individuals and their informal caregivers. We computed the total number of informal caregiving hours provided by main caregivers in Spain in 2008. The monetary value of informal care time was obtained using three different approaches: the proxy good method, the opportunity cost method and the contingent valuation method. RESULTS Total hours of informal care provided in 2008 were estimated at 4193 million and the monetary value ranged from EUR23,064 to EUR50,158 million depending on the method used. The value of informal care was estimated at figures equivalent to 1.73-4.90 % of the gross domestic product for that year. CONCLUSION Informal care represents a very high social cost regardless of the estimation method considered. A holistic approach to care of dependent people should take into account the role and needs of informal caregivers, promote their social recognition and lead to policies that enhance efficient use of formal and informal resources.
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Affiliation(s)
- Juan Oliva-Moreno
- University of Castilla La-Mancha, Research Seminar in Economics and Health, Toledo, Spain,
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