Yabroff K Robin, Kim Youngmee
Health Services and Economics Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland 20892-7344, USA.
Cancer. 2009 Sep 15;115(18 Suppl):4362-73. doi: 10.1002/cncr.24588.
To the authors' knowledge, little work has been done to estimate the time costs associated with informal caregiving for cancer survivors.
Data from a national survey of caregivers of cancer patients in 2003 to 2006 were used to estimate the time associated with informal caregiving in the 2 years after patient diagnosis with bladder, breast, colorectal, kidney, lung, melanoma of the skin, ovarian, prostate, or uterine cancer, or non-Hodgkins lymphoma (NHL). Caregivers reported the duration and daily intensity of caregiving as well as the types and frequency of support provided. The median wage rate in 2006 ($16.28) was used to value caregiver time, and other methods to value time were evaluated with sensitivity analyses.
On average, caregivers provided care for 8.3 hours per day for 13.7 months. The number of months and daily hours spent caregiving were the highest for cancer survivors diagnosed with distant disease compared with survivors with regional or localized disease (P<.05). Approximately half of caregivers provided emotional, instrumental, tangible, or medical support, although the frequency varied dramatically. Informal caregiver time costs over the 2-year period after diagnosis were the highest for caregivers of patients diagnosed with lung ($72,702; 95% confidence interval [95% CI], $56,814-$88,590) and ovarian ($66,210; 95% CI, $40,750-$91,670) cancers and NHL ($59,613; 95% CI, $43,423-$75,803) and the lowest for caregivers of patients with breast cancer ($38,334; 95% CI, $31,442-$45,226).
Time spent by informal caregivers was substantial and was an important component of the burden of cancer care. Incorporation of the value of informal caregiver time will be important when evaluating the costs and benefits of cancer control interventions.
据作者所知,在估算癌症幸存者非正式照护的时间成本方面,相关研究较少。
利用2003年至2006年一项针对癌症患者照护者的全国性调查数据,估算患者被诊断为膀胱癌、乳腺癌、结直肠癌、肾癌、肺癌、皮肤黑色素瘤、卵巢癌、前列腺癌或子宫癌,或非霍奇金淋巴瘤(NHL)后两年内非正式照护的时间。照护者报告了照护的时长和每日强度,以及提供支持的类型和频率。采用2006年的中位数工资率(16.28美元)来评估照护者的时间价值,并通过敏感性分析评估了其他时间价值评估方法。
照护者平均每天提供8.3小时的照护,时长为13.7个月。与诊断为局部或区域疾病的幸存者相比,诊断为远处疾病的癌症幸存者的照护月数和每日时长最多(P<0.05)。约一半的照护者提供了情感、工具性、实物或医疗支持,尽管频率差异很大。诊断后两年内,非正式照护者的时间成本在肺癌(72,702美元;95%置信区间[95%CI],56,814美元至88,590美元)、卵巢癌(66,210美元;95%CI,40,750美元至91,670美元)和NHL(59,613美元;95%CI,43,423美元至75,803美元)患者的照护者中最高,在乳腺癌患者的照护者中最低(38,334美元;95%CI,31,442美元至45,226美元)。
非正式照护者花费的时间相当可观,是癌症护理负担的重要组成部分。在评估癌症控制干预措施的成本和效益时,纳入非正式照护者时间的价值将很重要。