Hickenbottom S L, Fendrick A M, Kutcher J S, Kabeto M U, Katz S J, Langa K M
Department of Neurology, Consortium for Health Outcomes, Innovation, University of Michigan, Ann Arbor, USA.
Neurology. 2002 Jun 25;58(12):1754-9. doi: 10.1212/wnl.58.12.1754.
As the US population ages, increased stroke incidence will result in higher stroke-associated costs. Although estimates of direct costs exist, little information is available regarding informal caregiving costs for stroke patients.
To determine a nationally representative estimate of the quantity and cost of informal caregiving for stroke.
The authors used data from the first wave of the Asset and Health Dynamics (AHEAD) Study, a longitudinal study of people over 70, to determine average weekly hours of informal caregiving. Two-part multivariable regression analyses were used to determine the likelihood of receiving informal care and the quantity of caregiving hours for those with stroke, after adjusting for important covariates. Average annual cost for informal caregiving was calculated.
Of 7,443 respondents, 656 (8.8%) reported a history of stroke. Of those, 375 (57%) reported stroke-related health problems (SRHP). After adjusting for cormorbid conditions, potential caregiver networks, and sociodemographics, the proportion of persons receiving informal care increased with stroke severity, and there was an association of weekly caregiving hours with stroke +/- SRHP (p < 0.01). Using the median 1999 home health aide wage (8.20 dollars/hour) as the value for family caregiver time, the expected yearly caregiving cost per stroke ranged from 3,500 dollars to 8,200 dollars. Using conservative prevalence estimates from the AHEAD sample (750,000 US elderly patients with stroke but no SRHP and 1 million with stroke and SRHP), this would result in an annual cost of up to 6.1 billion dollars for stroke-related informal caregiving in the United States.
Informal caregiving-associated costs are substantial and should be considered when estimating the cost of stroke treatment.
随着美国人口老龄化，中风发病率上升将导致与中风相关的成本增加。尽管存在直接成本的估计，但关于中风患者非正式护理成本的信息却很少。
确定全国范围内具有代表性的中风非正式护理数量和成本估计值。
作者使用了资产与健康动态（AHEAD）研究第一波的数据，这是一项对70岁以上人群的纵向研究，以确定非正式护理的平均每周时长。在调整重要协变量后，使用两部分多变量回归分析来确定中风患者接受非正式护理的可能性以及护理时长。计算了非正式护理的平均年度成本。
在7443名受访者中，656人（8.8%）报告有中风病史。其中，375人（57%）报告有中风相关健康问题（SRHP）。在调整共病情况、潜在护理人员网络和社会人口统计学因素后，接受非正式护理的人员比例随着中风严重程度的增加而上升，并且每周护理时长与中风伴或不伴SRHP有关（p < 0.01）。以1999年家庭健康护理助理工资中位数（8.20美元/小时）作为家庭护理人员时间的价值，每例中风的预期年度护理成本在3500美元至8200美元之间。根据AHEAD样本中的保守患病率估计（75万美国老年中风患者无SRHP，100万伴有SRHP），这将导致美国中风相关非正式护理的年度成本高达61亿美元。
非正式护理相关成本巨大，在估计中风治疗成本时应予以考虑。
