Langa Kenneth M, Fendrick A Mark, Flaherty Kevin R, Martinez Ferndando J, Kabeto Mohammed U, Saint Sanjay
Division of General Medicine, Department of Internal Medicine, University of Michigan, 300 North Ingalls Building, Ann Arbor, MI 48109-0429, USA.
Chest. 2002 Dec;122(6):2197-203. doi: 10.1378/chest.122.6.2197.
To obtain nationally representative estimates of the additional time, and related cost, of unpaid family caregiving (informal caregiving) associated with chronic lung disease among older Americans.
Multivariable regression models using data from the 1993 Asset and Health Dynamics Study, a nationally representative survey of people > or = 70 years old (n = 7,443).
National population-based sample of the community-dwelling elderly.
Weekly hours of informal caregiving, and imputed cost of caregiver time, for community-dwelling elderly who reported the following: (1) no lung disease, (2) lung disease without associated activity limitations, or (3) lung disease with associated activity limitations.
After adjusting for sociodemographic variables, potential caregiver network, and comorbid conditions, individuals with chronic lung disease and associated activity limitations (n = 403) received an additional 5.1 h/wk of informal care when compared to those with no lung disease (n = 6,593; p < 0.001). The associated additional yearly cost of informal care per case was $2,200 USD. This represents a national annual cost of informal caregiving for chronic lung disease of > $2 billion USD.
The quantity and associated economic cost of informal caregiving for elderly individuals with chronic lung disease are substantial. These costs to families and society must be accounted for if the full societal costs of chronic lung disease are to be calculated. Pulmonary physicians caring for elderly individuals with chronic lung disease should be mindful of the importance of informal care for the well-being of their patients, as well as the potential for significant burden on those (often elderly) individuals providing the care.
获取具有全国代表性的关于美国老年人慢性肺病相关的无薪家庭照料(非正式照料)额外时间及相关成本的估计值。
使用1993年资产与健康动态研究的数据建立多变量回归模型,该研究是一项针对70岁及以上人群的全国代表性调查(n = 7443)。
以全国人口为基础的社区居住老年人样本。
针对报告以下情况的社区居住老年人,每周非正式照料的时长以及推算的照料者时间成本:(1)无肺病;(2)有肺病但无相关活动受限;(3)有肺病且有相关活动受限。
在对社会人口统计学变量、潜在照料者网络和共病情况进行调整后,与无肺病者(n = 6593)相比,患有慢性肺病且有相关活动受限的个体(n = 403)每周接受的非正式照料额外增加5.1小时(p < 0.001)。每例相关的非正式照料年度额外成本为2200美元。这意味着全国慢性肺病非正式照料的年度成本超过20亿美元。
慢性肺病老年个体的非正式照料数量及相关经济成本巨大。如果要计算慢性肺病的全部社会成本,必须考虑这些家庭和社会成本。照顾慢性肺病老年个体的肺科医生应意识到非正式照料对患者福祉的重要性,以及对那些(通常也是老年人)提供照料者造成巨大负担的可能性。