Monetary Value Of Informal Care Research Articles

Economic valuation and determinants of informal care to disabled people with Chronic Obstructive Pulmonary Disease (COPD).

BackgroundWe aimed to estimate the monetary value of informal care of disabled people with chronic obstructive pulmonary disease (COPD) in Spain and to identify the main determinants of the time involved in informal caregiving.MethodsWe used the Survey on Disabilities, Autonomy and Dependency carried out in Spain in 2008 to obtain information on disabled individuals with COPD and their informal caregivers. Assessment of informal caregiving time was performed using the proxy good method. A statistical multivariate analysis (ordered probit model) was performed to study the determinants of informal care provided.ResultsIt was estimated that 220,892 disabled people with COPD received informal care. The total annual number of caregiving hours was 694.44 million, with an estimated monetary value between 4,981 and 8,254 million EUR. Based on the condition of having received informal care, the cost of informal care per disabled person with COPD ranged from 24,549 to 40,681 EUR per year (depending on the shadow price applied). This value varies significantly depending on the degree of dependency; it ranged from 17,089 EUR per person annually for non-dependents to 33,033 EUR for those who were greatly dependent (under the most conservative scenario). Degree of dependency and the formal care received were the main variables that explained the variability of informal caregiving time provided.ConclusionsThe results partially reveal the high hidden social costs, and the association between the level of dependency and the time provided by the caregivers. This information should be a useful tool to design policies that focus on improving caregivers’ well-being.

Willingness to pay for informal care in France: the value of funding support interventions for caregivers.

ObjectivesThis article aims to assess the relationship between the monetary value of informal care - approximated with the caregiver's willingness to pay to reduce caregiving time - and the caregiver's need of three types of support services: care training, respite care and support group. Developing such services may be the only way to provide sustainable informal care in the future, along with efficient allocation.Data & MethodsData used stemmed from two representative national surveys conducted by French National Institute of Statistics and Economic Studies and the French Head Office of Research, Studies, Evaluation and Statistics of the Social Affairs Ministry in 2008. The contingent valuation method was used to approximate the monetary value of informal care. The model was run on 223 informal caregivers of people with Alzheimer's Disease. Statistical analyses were performed using Heckman's two-step estimation strategy, which is known to correct selection bias.ResultsOn average, one hour of informal care was estimated at €12.1. Monetary value of informal care was influenced by the caregiver's need of care training (p<0.01). No similar association was found for respite care or support group.DiscussionSince informal caring value increases with caregivers' need of care training, improving caring skills and capabilities through training support is likely to improve its benefits.

Economic valuation and determinants of informal care to people with Alzheimer's disease.

To estimate the monetary value of informal care to people with Alzheimer's disease (AD) in Spain and to identify the main determinants of the time of informal care. We used the Survey on Disabilities, Autonomy and Dependency carried out in Spain in 2008 to obtain information on disabled individuals with Alzheimer and their informal caregivers. Assessment of informal care time was performed using three different approaches: the proxy good method, the opportunity cost method and the contingent valuation method. A statistical multivariate analysis--an ordered probit model--was performed to study the determinants of informal care provided. The average number of required informal hours per year was 4,151. The cost per caregiver ranged from 31,839 to 52,760 euros under the proxy good method; it was estimated at 20,053 euros under the opportunity cost method; and it ranged between 18,680 and 29,057 euros under the contingent valuation method. The degree of dependency and the formal care services were the main variables that explained the variability of the informal time provided. When a person presents a very high level of dependency, the probability of receiving more than 100 h of informal care per week is 25.8% higher than a non-dependent person with AD. Formal in-home care complements informal caregiving, while formal care outside the home replaces it. Informal care represents a high social cost in people with AD, regardless of the estimation method considered. A higher level of dependence is associated with more hours of informal care provided.

Burgerparticipatie bij preventie: durven loslaten

Van oudsher is preventie het terrein waar de overheid de scepter zwaait. De grootste gezondheidswinst is in het verleden geboekt door landelijk ingevoerdepreventieve maatregelen, onder meer op het gebied van riolering, drinkwatervoorziening, huisvesting, vaccinatie en arbeidsomstandigheden. Echter, tijden zijn veranderd. De grootste uitdaging voor de publieke gezondheidszorg is niet langer uitsluitend gericht op het verhogen van de levensverwachting, maar ook op het verbeteren van de kwaliteit van leven bij ziekte, en het verkleinen van gezondheidsverschillen. De focus is verschoven van het grote collectiefnaar kleinere risicogroepen en het individu. Anno 2013 bestempelen we bemoeienis van de overheid met een ongezonde leefwijze, al gauw als betutteling.

Mantelzorg op waarde geschat

Valuation of informal care In the Netherlands many people provide informal care because they regard it as a natural thing to do. This mutual support is so common that its economic value is often overlooked. Informal care represents however a large capital. The monetary value of informal care of adults who provide long term and intensive help is estimated at € 6.6 billion (2007). The informal care is not only valued according to the time spent on care, but also to how much informal carers would be willing to spend on an additional hour of care (€ 9,52 per hour). Our findings suggests that the valuation of informal care is a useful technique in estimating the possible costs and effects of new policy measures in long term care.

Economic valuation of informal care in Asia: A case study of care for disabled stroke survivors in Thailand

This study values informal care for disabled stroke survivors in Thailand. It applies the conventional recommended opportunity cost method to value informal care in monetary terms. Data were collected by means of face-to-face interviews conducted during 2006. The sample consisted of 101 disabled persons who had suffered a stroke at least six months prior to the interview, and who had a functional status score of less than 95 as measured by the Barthel Index. Average monthly time spent on informal care was 94.6 hours, and the major source of opportunity cost was forgone unpaid work (43.5%). The average monthly monetary value of informal care was 4642.6 baht, based on 2006 prices. This study shows that providing informal care involves a substantial opportunity cost, implying a hidden value to Thai society.

Economic Valuation of Informal Care: Conjoint Analysis Applied in a Heterogeneous Population of Informal Caregivers

Objectives This article reports the results of the application of conjoint analysis (CA) to derive a monetary value of informal care. Compared with normally recommended valuation methods such as the opportunity cost method and proxy good method, a valuation elicited through a CA might be more sensitive to the heterogeneity and dynamics of informal care. Methods We developed a questionnaire and conducted a survey in which informal caregivers were asked to rate four different hypothetical informal caregiving situations (reflecting different combinations of care hours, care tasks, and monetary compensation). They were also asked to rate their current informal care situation compared with the four hypothetical situations. Data were obtained from postal questionnaires. These questionnaires were sent through regional support centres for informal caregivers of care recipients with various health problems. A total of 865 informal caregivers from this heterogeneous population returned a completed survey. Results Informal caregivers require an increase of 81% in their hourly compensation for providing 21 instead of 7 hours informal care per week. This implies a compensation of €12.36 per hour at a mean hypothetical compensation in the presented scenarios. We also found that an informal caregiver's current caregiving situation and other background characteristics were associated with the scenario ratings. Conclusions We conclude that a CA is a promising alternative for existing methods to determine a monetary value of informal care and encourage more experiments in this area.

An Overview of Methods and Applications to Value Informal Care in Economic Evaluations of Healthcare

This paper compares several applied valuation methods for including informal care in economic evaluations of healthcare programmes: the proxy good method; the opportunity cost method; the contingent valuation method (CVM); conjoint measurement (CM); and valuation of health effects in terms of health-related quality of life (HR-QOL) and well-being. The comparison focuses on three questions: what outcome measures are available for including informal care in economic evaluations of healthcare programmes; whether these measures are compatible with the common types of economic evaluation; and, when applying these measures, whether all relevant aspects of informal care are incorporated. All types of economic evaluation can incorporate a monetary value of informal care (using the opportunity cost method, the proxy good method, CVM and CM) on the cost side of an analysis, but only when the relevant aspects of time costs have been valued. On the effect side of a cost-effectiveness or cost-utility analysis, the health effects (for the patient and/or caregiver) measured in natural units or QALYs can be combined with cost estimates based on the opportunity cost method or the proxy good method. One should be careful when incorporating CVM and CM in cost-minimization, cost-effectiveness and cost-utility analyses, as the health effects of patients receiving informal care and the carers themselves may also have been valued separately. One should determine whether the caregiver valuation exercise allows combination with other valuation techniques. In cost-benefit analyses, CVM and CM appear to be the best tools for the valuation of informal care. When researchers decide to use the well-being method, we recommend applying it in a cost-benefit analysis framework. This method values overall QOL (happiness); hence it is broader than just HR-QOL, which complicates inclusion in traditional health economic evaluations that normally define outcomes more narrowly. Using broader, non-monetary valuation techniques, such as the CarerQol instrument, requires a broader evaluation framework than cost-effectiveness/cost-utility analysis, such as cost-consequence or multi-criteria analysis.

Economic valuation of informal care: Lessons from the application of the opportunity costs and proxy good methods

This paper reports the results of the application of the opportunity costs and proxy good methods to determine a monetary value of informal care. We developed a survey in which we asked informal caregivers in The Netherlands to indicate the different types of time forgone (paid work, unpaid work and leisure) in order to be able to provide care. Moreover, we asked informal caregivers how much time they spent on a list of 16 informal care tasks during the week before the interview. Data were obtained from surveys in two different populations: informal caregivers and their care recipients with stroke and with rheumatoid arthritis (RA). A total of 218 care recipients with stroke and their primary informal caregivers completed a survey as well as 147 caregivers and their care recipients with RA. The measurement of care according to both methods is more problematic compared to the valuation. This is especially the case for the opportunity costs method and for the housework part in the proxy good method. More precise guidelines are necessary for the consistent application of both methods in order to ensure comparability of results and of economic evaluations of health care.

Economic valuation of informal care: The conjoint measurement method applied to informal caregiving

This paper reports the results of the application of the conjoint measurement method (CM) to determine a monetary value of informal care. Compared to the normally recommended valuation methods, like the opportunity cost method and proxy good method, CM is probably better able to capture the heterogeneity of informal care. We developed a survey in which informal caregivers were asked to rate four different hypothetical informal caregiving situations, which differed with respect to care hours, care tasks and monetary compensation. Data were obtained from postal surveys. A total of 135 pairs of informal caregivers and care recipients with rheumatoid arthritis (RA) from the Netherlands returned a completed survey and were used in the analysis. Informal caregivers require an extra compensation of 1.00 euro per hour for providing one additional hour of the same informal care task (meaning that from the seventh to the eighth hour, they require 8 euro). For providing two extra hours of care, they require 2.00 euro compensation per hour. The relative valuation of informal care tasks is very diverse. Respondents require a compensation of 13.43 euro per hour for switching from providing light housework to personal care and 0.56 euro per hour for switching from providing personal care to heavy housework. Though CM is sometimes regarded as cognitively complex, 70% of the respondents were able and willing to evaluate the hypothetical caregiving scenarios. Elderly respondents especially had more difficulty with the method. In sum, CM is seen as a promising alternative for existing methods to determine a monetary value of informal care. The presented valuations of informal care can be incorporated in the numerator of a cost–effectiveness ratio in economic evaluations of health care.

Economic valuation of informal care: the contingent valuation method applied to informal caregiving.

This paper reports the results of the application of the contingent valuation method (CVM) to determine a monetary value of informal care. We discuss the current practice in valuing informal care and a theoretical model of the costs and benefits related to the provision of informal care. In addition, we developed a survey in which informal caregivers' willingness to accept (WTA) to provide an additional hour of informal care was elicited. This method is better than normally recommended valuation methods able to capture the heterogeneity and dynamics of informal care. Data were obtained from postal surveys. A total of 153 informal caregivers and 149 care recipients with rheumatoid arthritis returned a completed survey. Informal caregivers reported a mean WTA to provide a hypothetical additional hour of informal care of 9.52 Euro (n=124). Many hypotheses derived from the theoretical model and the literature were supported by the data.CVM is a promising alternative for existing methods like the opportunity cost method and the proxy good method to determine a monetary value of informal care that can be incorporated in the numerator of any economic evaluation.