Skip to main content
SpringerLink
Log in

An Estimation of the Value of Informal Care Provided to Dependent People in Spain

  • Original Research Article
  • Published:
Applied Health Economics and Health Policy Aims and scope Submit manuscript

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.

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

Access this article

Log in via an institution

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. Bonneux L, Van der Gaag N, Bijwaart G. Demographic epidemiologic projections of long-term care needs in selected European countries: Germany, Spain, The Netherlands and Poland. ENEPRI research report no 112. 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. Manton KG. Recent declines in chronic disability in the elderly US population: risk factors and future dynamics. Annu Rev Public Health. 2008;29:91–113.

    Article  PubMed  Google Scholar 

  4. Fries JF, Bruce B, Chakravarty E. Compression of Morbidity 1980–2011: a focused review of paradigms and progress. J Aging Res. 2011. Art Id 261702. http://dx.doi.org/10.4061/2011/261702.

  5. European Commission. The 2012 ageing report: economic and budgetary projections for the EU27 Member States (2010–2060). Directorate-General for Economic and Financial Affairs Brussels; 2012. Available at http://ec.europa.eu/economy_finance/publications/european_economy/2012/pdf/ee-2012-2_en.pdf.

  6. DG ECFIN. The impact of ageing on public expenditure: projections for the EU25 Member States on pensions, health care, long term care, education and unemployment transfers (2004–2050). European Economy, Special Report No 1/2006. 2006.

  7. Manton KG, Lamb VL, Gu X. Medicare cost effects of recent US disability trends in the elderly: future implications. J Aging Health. 2007;19:359–81.

    Article  PubMed  Google Scholar 

  8. OECD Indicators. Long-term care expenditure. Health at a glance 2011. ISBN: 9789264126107. doi:10.1787/health_glance-2011-en.

  9. Geerts J, Willemé P, Mot E (eds). Long-term care use and supply in Europe: projection for Germany, The Netherlands, Spain and Poland. ENEPRI Research Report No. 116/April 2012. Available at http://aei.pitt.edu/34721/1/RR_No_116__ANCIEN_WP6__Projecting_LTC_Use_%26_Supply.pdf.

  10. Comas-Herrera A, Wittenberg R, Costa-Font J, Gori C, Di Maio A, Patxot C. Future long-term care expenditure in Germany, Spain, Italy and the United Kingdom. Ageing Soc. 2006;26:285–302.

    Article  Google Scholar 

  11. García-Gómez P, Hernandez-Quevedo C, Jiménez-Rubio D, Oliva-Moreno J. Inequity in long-term care use and unmet need: two sides of the same coin. J Health Econ. In press.

  12. Hoefman R, Van Exel J, Brouwer W. How to include informal care in economic evaluations. Pharmacoeconomics. 2013;31(12):1105–19.

    Article  PubMed  Google Scholar 

  13. Peña-Longobardo LM, Oliva-Moreno J. Economic valuation and determinants of informal care to people with Alzheimer`s disease. Eur J Health Econ. 2014. doi:10.1007/s10198-014-0604-6.

  14. van den Berg B, Brouwer WB, Koopmanschap MA. Economic valuation of informal care. An overview of methods and applications. Eur J Health Econ. 2004;5(1):36–45.

    Article  PubMed  Google Scholar 

  15. Arno PS, Levine C, Memmott MM. The economic value of informal caregiving. Health Aff. 1999;18(2):182–8.

    Article  CAS  Google Scholar 

  16. Buckner L, Yeandle S. Valuing carers 2011. Calculating the value of carers’ support. Centre for International Research on care, Labour & Equalitites 2011. Available at http://www.google.es/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0CCEQFjAA&url=http%3A%2F%2Fcircle.leeds.ac.uk%2Ffiles%2F2012%2F08%2F110512-circle-carers-uk-valuing-carers.pdf&ei=UyX0VKffLMPrUrX9gtgC&usg=AFQjCNGrHmdifZIMB3Ox5kL4-jaAz-Tn_Q.

  17. Gibson MJ, Houser A. Valuing the invaluable: a new look at the economic value of family caregiving. AARP Public Public Policy Institute. 2008;(IB82):1–12.

  18. Chari AV, Engberg J, Ray K, Mehrotra A. The opportunity costs of informal elder-care in the United States: new estimates from the American Time Use Survey. Health Serv Res. doi:10.1111/1475-6773.12238.

  19. 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. 2006;15(5):447–60.

    Article  PubMed  Google Scholar 

  20. 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. 2006;62(4):835–45.

    Article  PubMed  Google Scholar 

  21. Survey of disabilities, personal autonomy and dependency status 2008. National Statistic Institute.

  22. 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, editor. RD 504/2007; 2006.

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

    Article  CAS  PubMed  Google Scholar 

  24. Smith K, Wright K. Informal care and economic appraisal: a discussion of possible methodological approaches. Health Econ. 1994;3(3):137–48.

    Article  CAS  PubMed  Google Scholar 

  25. Luce BR, Wanning WG, Siegel JE, Lipscomb J. Estimating cost in cost-effectiveness analysis. In: Gold MR, Siegel JE, Russell LB, Weinstein MC, editors. Cost-effectiveness in health and medicine. New York: Oxford University Press; 1996.

    Google Scholar 

  26. IMSERSO. Las Personas Mayores en España. Datos estadísticos Estatales y por Comunidades Autónomas. Ministerio de Edcuación, Política Social y Deporte. 2008.

  27. The Living Condition Survey 2009. National Institute of Statistics. Available at: http://www.ine.es/jaxi/menu.do?type=pcaxis&path=/t25/p453&file=inebase.

  28. Ministerio de Empleo y Seguridad Social. Guía Laboral. Retribuciones de los trabajadores por cuenta ajena y su garantía. 2008.

  29. Garrido S, Abellán JM, Sánchez FI. Valoración monetarie de los cuidados informales a partir de la disposición a aceptar de cuidadores y no cuidadores. XXXIII Jornadas de Economía de la Salud. 2013.

  30. Fast JE, Williamson DL, Keating N. The hidden costs of informal elder care. J Fam. 1999;20:301–26.

    Google Scholar 

  31. Van Exel N, van den Bos G, van den Berg B. What really matters: an inquiry into the relative importance of dimensions of care giving burden. Clin Rehabil. 2004;18:693.

    Google Scholar 

  32. Hirst M. Carer distress: a prospective, population-based study. Soc Sci Med. 2005;61:697–708.

    Article  PubMed  Google Scholar 

  33. Oliva-Moreno J. Loss of labour productivity caused by disease and health problems: What is the magnitude of its effect on Spain’s economy? Eur J Health Econ. 2012;13(5):605–14.

    Article  PubMed  Google Scholar 

  34. Stiglitz JE, Sen A, Fitoussi J. Report by the commission on the measurement of economic performance and social progress. Available at http://www.google.es/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&cad=rja&uact=8&ved=0CC0QFjAC&url=http%3A%2F%2Fwww.stiglitz-sen-fitoussi.fr%2Fdocuments%2Frapport_anglais.pdf&ei=_Sf0VL3fD8KAU56CgvAF&usg=AFQjCNGGNUiuOiyL98AV3smKWiuucnl1sA.

  35. Spanish Ministry of Health and Social Policies. Informe del gobierno para la evaluación de la ley 39/2006, de 14 de diciembre, de promoción de la autonomía personal y atención a las personas en situación de dependenciad; Madrid. 2011.

  36. European Commission. Directorate-General for Economic and Financial Affairs. European Economy No. 2/2012. 2012 Ageing Report: Economic and budgetary projections for the EU-27 Member States (2010–2060). 2012.

Download references

Acknowledgments

The authors are grateful to the Instituto de Estudios Fiscales for funding the research project of which this study is a part. They also received support from the research project ECO2013-48217-C2-2-R of the Spanish Ministry of Economy and Competitiveness and ECO2011-30323-C03-02 from the Spanish Ministry of Science and Technology.

Conflicts of interest

Authors of this paper have no conflicts of interest.

Authors’ contribution

Juan Oliva-Moreno (JOM) and Luz María Peña-Longobardo (LMPL) conceived the study. JOM and Cristina Vilaplana-Prieto (CVP) conducted the systematic search of the literature. LMPL and CVP carried out the estimations. JOM and LMPL wrote the first version of the manuscript. All authors contributed to review of the different versions of the manuscript and accepted the final version. JOM is the guarantor for the overall content.

Author information

Authors and Affiliations

  1. University of Castilla La-Mancha, Research Seminar in Economics and Health, Toledo, Spain

    Juan Oliva-Moreno & Luz María Peña-Longobardo

  2. University of Murcia, Murcia, Spain

    Cristina Vilaplana-Prieto

  3. Facultad de Ciencias Jurídicas y Sociales de Toledo, Análisis Económico y Finanzas, Universidad de Castilla la Mancha, Cobertizo de San Pedro Mártir s/n, 45071, Toledo, Spain

    Juan Oliva-Moreno

Authors
  1. Juan Oliva-Moreno
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Luz María Peña-Longobardo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cristina Vilaplana-Prieto
    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

Oliva-Moreno, J., Peña-Longobardo, L.M. & Vilaplana-Prieto, C. An Estimation of the Value of Informal Care Provided to Dependent People in Spain. Appl Health Econ Health Policy 13, 223–231 (2015). https://doi.org/10.1007/s40258-015-0161-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40258-015-0161-x

Keywords

Search

Navigation