Andersson Agneta, Carstensen John, Levin Lars-Ake, Emtinger Bengt Göran
Department of Health and Society, Linköping Universitet, Sweden.
Int J Technol Assess Health Care. 2003 Fall;19(4):656-63. doi: 10.1017/s0266462303000618.
Several studies have sought to analyze the cost-effectiveness of advanced home care and home rehabilitation. However, the costs of informal care are rarely included in economic appraisals of home care. This study estimates the cost of informal care for patients treated in advanced home care and analyses some patient characteristics that influence informal care costs.
During one week in October 1995, data were collected on all 451 patients in advanced home care in the Swedish county of Ostergötland. Costs were calculated by using two models: one including leisure time, and one excluding leisure time. Multiple regression analysis was used to analyze factors associated with costs of informal care.
Severity percent of the patients in the study had informal care around the clock during the week investigated. The patients had, on average, five formal care visits per week, each of which lasted for almost half an hour. Thus, the cost of informal care constituted a considerable part of the cost of advanced home care. When the cost of leisure time was included, the cost of informal care was estimated at SEK 5,880 per week per patient, or twice as high as total formal caregiver costs. When leisure time was excluded, the cost of informal care was estimated at SEK 3,410 per week per patient, which is still 1.2 times higher than formal caregiver costs (estimated at SEK 2,810 per week per patient). Informal care costs were higher among patients who were men, who were younger, who had their own housing, and who were diagnosed with cancer.
Studies of advanced home care that exclude the cost of informal care substantially underestimate the costs to society, regardless of whether or not the leisure time of the caregiver is included in the calculations.
多项研究试图分析高级家庭护理和家庭康复的成本效益。然而，非正式护理的成本很少被纳入家庭护理的经济评估中。本研究估计了接受高级家庭护理患者的非正式护理成本，并分析了一些影响非正式护理成本的患者特征。
1995年10月的一周内，收集了瑞典东约特兰郡所有451名接受高级家庭护理患者的数据。成本通过两种模型计算：一种包括休闲时间，另一种不包括休闲时间。多元回归分析用于分析与非正式护理成本相关的因素。
在调查的一周内，研究中相当比例的患者接受了全天候的非正式护理。患者平均每周接受五次正式护理访视，每次访视持续近半小时。因此，非正式护理成本占高级家庭护理成本的相当一部分。当包括休闲时间成本时，估计每位患者每周的非正式护理成本为5880瑞典克朗，是正式护理人员总成本的两倍。当不包括休闲时间时，估计每位患者每周的非正式护理成本为3410瑞典克朗，仍比正式护理人员成本高1.2倍（估计每位患者每周为2810瑞典克朗）。男性、年轻、有自有住房且被诊断患有癌症的患者的非正式护理成本更高。
无论计算中是否包括护理人员的休闲时间，排除非正式护理成本的高级家庭护理研究都大大低估了社会成本。
