Dementia Family Caregivers’ Willingness to Pay for an In-home Program to Reduce Behavioral Symptoms and Caregiver Stress
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Our objective was to determine whether family caregivers of people with dementia (PwD) are willing to pay for an in-home intervention that provides strategies to manage behavioral symptoms and caregiver stress and to identify predictors of willingness-to-pay (WTP).
During baseline interviews of a randomized trial and before treatment assignment, caregivers were asked how much they were willing to pay per session for an eight-session program over 3 months. We stratified the sample into those who refused to provide a WTP, those willing to pay $US0, and those willing to pay > $US0. We used a two-part model, controlling for demographic characteristics, to predict adjusted mean WTP and to examine associations between WTP, clinical features (cognition, function, behavioral symptoms), and time spent assisting PwD with daily activities. First, we used logistic regression to model the probability a caregiver was willing to pay > $US0. Second, we used a generalized linear model (log link and Gamma distribution) to estimate the amount caregivers were willing to pay conditional on WTP > $US0.
Of 250 dyads enrolled, 226 (90%) had complete data and were included in our analyses. Of 226 dyads, 26 (11%) refused to provide a WTP value, 72 (32%) were willing to pay $US0, and 128 (57%) were willing to pay > $US0. In the combined model, mean adjusted WTP was $US36.00 (95% confidence interval [CI] 26.72–45.27) per session. Clinical features were not significantly associated with WTP. One additional hour providing PwD assistance was associated with a $US1.64 (95% CI 0.23–3.04) increase in WTP per session.
As caregivers spend more time assisting with daily activities, they are willing to pay more for a supportive program.
Clinical Trial Registration Number
EJ, LTP, KM, LNG: study design and analysis. All authors participated in the interpretation of data, drafting of manuscript, critical revision of manuscript, and approval of final manuscript.
Compliance with Ethical Standards
This dataset is available upon request from the senior author (Dr. Laura N. Gitlin).
This study was supported by a grant from the National Institute on Aging (Grant #R01 AG041781-01A1).
Conflicts of interest
EJ, DS, LTP, KM, QS, CVP, and LNG have no conflicts of interest that are directly relevant to the content of this article. LNG is an inventor of a training program for the TAP intervention for which Johns Hopkins University is entitled to fees. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies.
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