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阿尔茨海默病和其他精神障碍患者的非正式护理的无形影响的经济分析。

Economic analysis of the intangible impacts of informal care for people with Alzheimer's disease and other mental disorders.

机构信息

EHESP - SHSC, Avenue du professeur Léon-Bernard CS 74312, 35012 Rennes, France.

出版信息

Value Health. 2013 Jul-Aug;16(5):745-54. doi: 10.1016/j.jval.2013.03.1629. Epub 2013 Jun 15.

Abstract

OBJECTIVES

Valuation of the intangible impacts of informal care remains a great challenge for economic evaluation, especially in the framework of care recipients with cognitive impairment. Our main objective was to explore the influence of intangible impacts of caring on both informal caregivers' ability to estimate their willingness to pay (WTP) to be replaced and their WTP value.

METHODS

We mapped characteristics that influence ability or inability to estimate WTP by using a multiple correspondence analysis. We ran a bivariate probit model with sample selection to further analyze the caregivers' WTP value conditional on their ability to estimate their WTP.

RESULTS

A distinction exists between the opportunity costs of the caring dimension and those of the intangible costs and benefits of caring. Informal caregivers' ability to estimate WTP is negatively influenced by both intangible benefits from caring (P < 0.001) and negative intangible impacts of caring (P < 0.05). Caregivers' WTP value is negatively associated with positive intangible impacts of informal care (P < 0.01).

CONCLUSIONS

Informal caregivers' WTP and their ability to estimate WTP are both influenced by intangible burden and benefit of caring. These results call into question the relevance of a hypothetical generalized financial compensation system as the optimal way to motivate caregivers to continue providing care.

摘要

目的

评估非正规护理的无形影响仍然是经济评估的一大挑战,特别是在认知障碍的护理接受者框架内。我们的主要目的是探讨照顾的无形影响对非正式照顾者估计替代意愿支付(WTP)能力及其 WTP 值的影响。

方法

我们使用多元对应分析来描绘影响能力或无法估计 WTP 的特征。我们进行了具有样本选择的双变量概率模型分析,以进一步分析在能够估计 WTP 的情况下照顾者的 WTP 值。

结果

照顾维度的机会成本与照顾的无形成本和收益的机会成本之间存在区别。照顾的无形收益(P<0.001)和照顾的负面无形影响(P<0.05)都对非正式照顾者估计 WTP 的能力产生负面影响。照顾者的 WTP 值与非正式照顾的积极无形影响呈负相关(P<0.01)。

结论

非正式照顾者的 WTP 及其估计 WTP 的能力都受到照顾的无形负担和收益的影响。这些结果质疑了假设的广义财务补偿制度作为激励照顾者继续提供照顾的最佳方式的相关性。

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