PMU43 - THE COST OF INFORMAL CARE IN HUNGARY: A POOLED ANALYSIS OF 14 CROSS-SECTIONAL STUDIES

Abstract

Informal care is non-financed care outside the healthcare sector, which represents an increasing challenge for aging societies. Informal care has frequently been neglected in health economic analyses. Our objective was to analyse informal care costs in patients with chronic diseases in Hungary. A pooled analysis of patient-level data from 14 cross-sectional, retrospective, cost-of-illness studies was performed. Demographic variables, informal care hours and costs were analysed. Two alternative scenarios were posited for valuing informal care, the opportunity cost and the proxy good methods were applied. Average hourly net wage (i.e. €3.8/hour) was used as the opportunity costs of one informal care hour. In the proxy good scenario, the caregiver hours were valued as an average price of private providers (i.e. €5.5/hour). Patient level costs of informal care were recalculated for the reference year 2017. All the costs were converted to Euros on an exchange rate of €1 = HUF 309.2. Sample size of included studies ranged between 68 (multiple sclerosis) and 255 (rheumatoid arthritis), altogether 2,000 patients were enrolled in the analysis. Mean age was 58.2±16.5 (range 18-99) years, and 60.1% were females. A total of 538 (26.9%) patients received any informal care, of which dementia was the most (89.5%) and benign prostate hyperplasia the least affected (6.5%). The average yearly informal care costs applying the opportunity costs or the proxy good methods were 46.2 and 66.4 €/patient, respectively. The highest average informal care costs were observed in dementia (127.0 and 182.5 €/patient), followed by multiple sclerosis (51.5 and 74.1 €/patient) and Parkinson’s disease (33.2 and 47.7 €/patient). Females were associated with 1.3 times higher informal care costs than males (p=0.03). Age demonstrated a weak, positive correlation (p=0.143) with informal care costs. Informal care costs represent a substantial burden in chronic diseases. Valuation method might have significant effect on cost estimates.