Building 16 HSRD, VAMC, 508 Fulton Street (558/152), Durham, NC 27705, USA.
Oncologist. 2010;15(8):883-93. doi: 10.1634/theoncologist.2010-0005. Epub 2010 Jul 28.
Informal care provides many benefits to cancer patients, but can be costly to caregivers. This study quantified the economic burden for informal caregivers of lung cancer (LC) and colorectal cancer (CRC) patients, examining differences by cancer type, phase of disease, stage at diagnosis, patient age, and relationship.
A cross-sectional survey of caregivers of LC and CRC patients participating in the Share Thoughts on Care survey was conducted. Economic burden was calculated using the opportunity cost of caregiver time, the value of work hours lost, and out-of-pocket expenditures. Factors associated with economic burden to caregivers were modeled using fixed-effects generalized least squares estimation.
Informal caregivers (1,629) completed mailed surveys. Of these, 663, 822, and 144 were surveyed during the patient's initial phase (first year after diagnosis, not within 6 months of death), continuing phase (after 1 year, not within 6 months of death), and terminal phase (within 6 months of death) of disease, respectively. The accumulated economic burdens for caregivers were $7,028, $19,701, and $14,234 for those evaluated during the patient's initial phase, continuing phase, and terminal phase of disease, respectively. Economic burden was higher for caregivers of LC patients than CRC patients (p = .044) and for caregivers of patients diagnosed at stage 4 versus stage 1 (p = .001). Spouses faced higher economic burden than other relatives (p = .000) or friends (p = .000).
Economic burden for informal caregivers of LC and CRC patients is substantial and should be included in estimates of the societal cost of cancer care.
非正规护理为癌症患者带来了许多益处,但对护理人员来说可能代价高昂。本研究通过量化肺癌(LC)和结直肠癌(CRC)患者非正规护理人员的经济负担,考察了癌症类型、疾病阶段、诊断时的分期、患者年龄和关系的差异。
对参与“分享护理心得”调查的 LC 和 CRC 患者的护理人员进行了横断面调查。经济负担通过护理人员时间的机会成本、失去的工作时间价值和自付支出来计算。使用固定效应广义最小二乘估计对与护理人员经济负担相关的因素进行建模。
1629 名非正规护理人员完成了邮寄调查。其中,663、822 和 144 名护理人员分别在患者初始阶段(诊断后 1 年内,距死亡不到 6 个月)、持续阶段(1 年后,距死亡不到 6 个月)和终末期(距死亡不到 6 个月)接受了调查。评估的患者处于初始阶段、持续阶段和终末期疾病的护理人员的累积经济负担分别为 7028 美元、19701 美元和 14234 美元。LC 患者护理人员的经济负担高于 CRC 患者(p =.044),4 期诊断患者的护理人员高于 1 期诊断患者(p =.001)。配偶比其他亲属(p =.000)或朋友(p =.000)面临更高的经济负担。
LC 和 CRC 患者非正规护理人员的经济负担很大,应包括在癌症护理社会成本的估计中。