Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Paper
  • Published:
The European Journal of Health Economics Aims and scope Submit manuscript

Abstract

Objective

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.

Data and methods

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.

Results

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.

Conclusions

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. The 2012 ageing report. Underlying Assumptions and Projection Methodologies. European Commission. In. (2012)

  2. Lafortune, G., Balestat, G.: Trends in severe disability among elderly people: Assessing the evidence in 12 OECD countries and the future implications. OECD health working papers (2007)

  3. Christensen, K., Doblhammer, G., Rau, R., Vaupel, J.W.: Ageing populations: the challenges ahead. Lancet 374(3), 1196–1208 (2009)

    Article  PubMed Central  PubMed  Google Scholar 

  4. Fries, J.F., Bruce, B., Chakravarty, E.: Compression of Morbidity 1980–2011: a focused review of paradigms and progress. J. Aging Res. (2011)

  5. De la Torre Prados, I., Ruiz, O., Fernández, M., Ayuso, L., García, L.M., Rogero, J.: Dependencia y familia: una perspectiva socio-económica. (2010)

  6. Corduras, A., Rabasa, I., Frank, A., Bermejo-Pareja, F., López-Pousa, S., López-Arrieta, J.M., Del Lano, J., León, T., Rejas, J.: Prospective One-Year Cost of illness study in a Cohort of patients with dementia of Alzhiemer’s disease type in Spain: The ECO study. J Alzheimer’s Dis 19(2), 601–615 (2010)

  7. Georges, J., Jansen, S., Jackson, J., Meyrieux, A., Sadowska, A., Selmes, M.: Alzheimer’s disease in real life: the dementia carer’s survey. Int. J. Geriatr. Psychiat. 23(5), 546–551 (2008)

    Article  Google Scholar 

  8. Long-term care expenditure. Health at a Glance 2011. OECD Indicators. (2011)

  9. Long-term Care Use and Supply in Europe: Projections for Germany, The Netherland, Spain and Poland. ANCIEN. (2012)

  10. Zhu, C.W., Torgan, R., Scarmeas, N., Albert, M., Brandt, J., Blancker, D., Sano, M., Stern, Y.: Home health and informal care utilization and costs over time in Alzheimer’s disease. Home Health Care Serv. 27, 1–20 (2008)

    Article  Google Scholar 

  11. Rivera, B., Casa, B., Currais, L.: Provisión de cuidados informales y enfermedad de Alzheimer: valoración económica y estudio de la variabilidad del tiempo. Revista de Economia Pública 189, 107–130 (2009)

    Google Scholar 

  12. López-Bastida, J., Serrano, P., Perestelo-Perez, L., Oliva, J.: Social-economic costs and quality of life of Alzheimer’s disease in the Canary Islands. Neurology 67, 2186–2191 (2006)

    Article  PubMed  Google Scholar 

  13. Sicras, A., Rejas, J., Arco, S., Flores, E., Ortega, G., Esparcia, A., Suárez, A., Gordillo, M.J.: Prevalence, resource utilization and costs of vascular dementia compared to Alzheimer’s dementia in a population setting. Dement. Geriatr. Cogn. Disord. 19(5–6), 305–315 (2005)

    Article  CAS  PubMed  Google Scholar 

  14. Turró-Garriga, O., López-Pousa, S., Vilalta-Franch, J., A., T.-E., Pericot-Nierga, I., Lozano-Gallego, M., Hernández-Ferrándiz, M., Soler-Cors, O., Planas-Pujol, X., Monserrat, S., Garre-Olmo, J.: Valor económico anual de la asistencia informal en la enfermedad de Alzheimer. Rev Neurol 51(4), 201–207 (2010)

  15. Cavallo, M., Fattore, G.: The economic and social burden of Alzheimer’s disease on families in the Lombardy region of Italy. Alzheimer Dis. Assoc. Disord. 11(4), 184–190 (1997)

    CAS  PubMed  Google Scholar 

  16. León, J., Cheng, C., Neumann, P.J.: Alzheimer’s disease care: costs and potential savings. Health Aff. 17, 206–216 (1998)

    Article  Google Scholar 

  17. Rigaud, A.S., Fagnani, F., Bayle, C., Latour, F., Traykov, L., Forette, F.: Patients with Alzheimer’s disease living at home in France: costs and consequences of the disease. J. Geriatr. Psychiatry Neurol. 16, 140–145 (2003)

    Article  PubMed  Google Scholar 

  18. Luengo-Fernandez, R., Leal, J., Gray, A.M.: Cost of dementia in the pre-enlargement countries of the European Union. J. Alzheimers Dis. 27(1), 187–196 (2011)

    PubMed  Google Scholar 

  19. Jönsson, L., Eriksdotter Jönhagen, M., Kilander, L., Soininen, H., Hallikainen, M., Waldemar, G., Nygaard, H., Andreasen, N., Winblad, B., Wimo, A.: Determinants of costs of care for patients with Alzheimer’s disease. Int. J. Geriatr. Psychiatry. 21(5), 449–459 (2006)

    Article  PubMed  Google Scholar 

  20. Survey of Disabilities, Personal Autonomy and Dependency Status. National Statistic Institute. (2008)

  21. Posnett, J., Jan, S.: Indirect cost in economic evaluation: the opportunity cost of unpaid inputs. Health Econ. 5(1), 13–23 (1996)

    Article  CAS  PubMed  Google Scholar 

  22. Smith, K., Wright, K.: Informal care and economic appraisal: a discussion of possible methodological approaches. Health Econ. 3(3), 137–148 (1994)

    Article  CAS  PubMed  Google Scholar 

  23. Luce, B.R., Wanning, W.G., Siegel, J.E., Lipscomb, J.: Estimating cost in cost-effectiveness analysis. In: Gold, M.R., Siegel, J.E., Russell, L.B., Weinstein, M.C. (eds.) Cost-effectiveness in health and medicine. Oxford University Press, New Jork (1996)

    Google Scholar 

  24. van den Berg, B., Brouwer, W.B., Koopmanschap, M.A.: Economic valuation of informal care. An overview of methods and applications. Eur. J. Health Econ. 5(1), 36–45 (2004)

    Article  PubMed  Google Scholar 

  25. van den Berg, B., Brouwer, W., van Exel, J., Koopmanschap, M., van den Bos, G., Rutten, F.: Economic valuation of informal care: lessons from the application of the opportunity costs and proxy good methods. Soc. Sci. Med. 62(4), 835–845 (2006)

    Article  PubMed  Google Scholar 

  26. van den Berg, B., Spauwen, P.: Measurement of informal care: an empirical study into the valid measurement of time spent on informal caregiving. Health Econ. 15(5), 447–460 (2006)

    Article  PubMed  Google Scholar 

  27. Informe 2008. Las personas mayores en España. Datos estadísticos estatales y por comunidades autónomas. Ministerio de Edcuación, Política Social y Deporte. IMSERSO. In. (2008)

  28. Instituto Nacional de Estadística. Encuesta de Estructura Salarial. (2008)

  29. Ministerio de Empleo y Seguridad Social. Guía Laboral. Retribuciones de los trabajadores por cuenta ajena y su garantía.: In. (2008)

  30. Garrido, S., Abellán, J.M., Sánchez, F.I.: Valoración monetaria de los cuidados informales a partir de la disposición a aceptar de cuidadores y no cuidadores. XXXIII Jornadas de Economía de la Salud. In. (2013)

  31. Real Decreto 504/2007, de 20 de abril, por el que se aprueba el baremo de valoración de la situación de dependencia establecido por la Ley 39/2006, de 14 de diciembre, de promoción de la autonomía personal y atención a las personas en situación de dependencia. In: Spanish Goverment (ed.) R.D 504/2007, vol. Law 39/2006 14 December. (2006)

  32. Greene, W.: Econometric analysis. Prentice Hall, New York (2003)

    Google Scholar 

  33. Jones, A.M.: Health econometrics. In: Culyer, A.J., Newhouse, J.P. (eds.) Handbook of health economics. Elsevier, Amsterdam (2000)

    Google Scholar 

  34. Jones, A.M.: Applied econometrics for health economists-a practical guide. Office of Health Economics, Whitehall London (2001)

    Google Scholar 

  35. Maddala, G.S.: Limited-dependent and qualitative variables in econometrics, vol. 3. Econometric Society Monographs in quantitative economics (1983)

  36. Informe del Gobierno para la evaluación de la Ley de promoción de la autonomía personal y atención a las personas en situación de dependencia. Ministerio de Sanidad, Política social e igualdad. (4 de Noviembre 2011)

  37. Cantor, M.: Neighbours and friends: and overlooked resource in the informal support system. Res. Aging 1, 434–463 (1979)

    Article  Google Scholar 

  38. Greene, V.: Substitution between formally and informally provided care for the impaired elderly in the community. Med. Care 21, 609–619 (1983)

    Article  CAS  PubMed  Google Scholar 

  39. Chappel, N., Blandford, A.: Informal and formal care: exploring the complementarity. Ageing Soc. 11, 299–315 (1991)

    Article  Google Scholar 

  40. Van Houtven, C., Norton, E.: Informal care and health care use of older adults. J. Health Econ. 23, 1159–1180 (2004)

    Article  PubMed  Google Scholar 

  41. Muramatsu, N., Hongjun, Y., Campbell, R., Hoyem, R., Jacob, M., Ross, C.: Risk of nursing home admission among older Americans: does the state’s spending on home-and-community-based services matter? J. Gerontol. B Psychol. Sci. Soc. Sci. 62, S169–S178 (2007)

    Article  PubMed Central  PubMed  Google Scholar 

  42. Viitanen, T.K.: Informal and formal care in Europe. Institute for the Study of Labour No. 2648 (2007)

  43. Jiménez, S., Vilaplana, C.: The trade off between formal and informal care in Spain. Eur. J. Health Econ. 13(4), 461–490 (2012)

    Article  Google Scholar 

  44. De Rus, G., Betancor, O., Campos, J.: Evaluación económica de proyectos de transporte. Banco Interamericano de Desarrollo, Washington DC (2006)

    Google Scholar 

  45. Hurd, M.D., Martorell, P., Delavande, A., Mullen, K., Langa, K.: Monetary cost of dementia in the United States. New England J Med 369(5), 489–490 (2013)

    Article  CAS  Google Scholar 

Download references

Acknowledgments

We would like to express our appreciation for the stimulating and constructive comments received from Leocadio Rodríguez Mañas, José Mª Labeaga and Isaac Aranda. We also thank the attendees of the seminars that took place at Castilla-La Mancha University and in the Jornadas de Economía de la Salud organized by the Asociación de Economía de la Salud [Spanish Association of Health Economics] (AES).

Author information

Authors and Affiliations

  1. Faculty of Law and Social Sciences, University of Castilla-La Mancha, Toledo, Spain

    Luz María Peña-Longobardo & Juan Oliva-Moreno

  2. Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Toledo, Spain

    Juan Oliva-Moreno

Authors
  1. Luz María Peña-Longobardo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Juan Oliva-Moreno
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Juan Oliva-Moreno.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Peña-Longobardo, L.M., Oliva-Moreno, J. Economic valuation and determinants of informal care to people with Alzheimer’s disease. Eur J Health Econ 16, 507–515 (2015). https://doi.org/10.1007/s10198-014-0604-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10198-014-0604-6

Keywords

JEL Classification

Search

Navigation