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重视受照顾者和家庭照顾者的时间:方法比较

Valuing care recipient and family caregiver time: a comparison of methods.

作者信息

Guerriere Denise N, Tranmer Jennifer E, Ungar Wendy J, Manoharan Venika, Coyte Peter C

机构信息

Assistant Professor, Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

出版信息

Int J Technol Assess Health Care. 2008 Winter;24(1):52-9. doi: 10.1017/S0266462307080075.

Abstract

OBJECTIVES

The purpose of this study is to compare the approaches used for valuing family caregiver and care recipient time devoted to providing and receiving care.

METHODS

Valuation approaches were operationalized within a cohort of cystic fibrosis care recipients (n = 110). Base-case analyses, grounded in human capital theory, applied earnings estimates to caregiving time to impute the market value of time lost from labor. Unpaid labor and leisure time was valued with a replacement cost (homemaker's wage rate). Total time costs were computed and sensitivity analyses were conducted to describe the effects of alternative valuation methods on total costs.

RESULTS

The mean time cost per care recipient-caregiver dyad over 28 days was $2,026CAD. The majority (76 percent) of time costs were due to losses from unpaid labor and leisure time. Varying the valuation of paid labor time did not result in significantly different total time costs (p = .0877). However, varying the method of valuing unpaid labor and leisure time did significantly affect total costs (p < .0001).

CONCLUSIONS

Care recipients and caregivers primarily lost time from unpaid labor and leisure in the treatment of cystic fibrosis. Moreover, when the above losses were aggregated, the method of valuation greatly influenced overall results. The findings clearly indicate that omitting caregiver and unpaid labor and leisure costs may result in an inaccurate assessment of ambulatory and home-based healthcare programs.

摘要

目的

本研究旨在比较评估家庭照顾者和受照顾者投入到提供和接受护理的时间所采用的方法。

方法

在一组囊性纤维化患者(n = 110)中实施评估方法。基于人力资本理论的基础案例分析,将收入估算应用于护理时间,以推算因劳动而损失的时间的市场价值。无薪劳动和休闲时间采用替代成本(家庭主妇工资率)进行估值。计算总时间成本,并进行敏感性分析,以描述替代估值方法对总成本的影响。

结果

每位受照顾者 - 照顾者二元组在28天内的平均时间成本为2,026加元。大部分(76%)的时间成本是由于无薪劳动和休闲时间的损失。改变有偿劳动时间的估值并未导致总时间成本有显著差异(p = 0.0877)。然而,改变无薪劳动和休闲时间的估值方法确实对总成本有显著影响(p < 0.0001)。

结论

在囊性纤维化治疗中,受照顾者和照顾者主要在无薪劳动和休闲方面损失时间。此外,当汇总上述损失时,估值方法对总体结果有很大影响。研究结果清楚地表明,忽略照顾者以及无薪劳动和休闲成本可能会导致对门诊和家庭医疗保健项目的评估不准确。

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