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心力衰竭患者非正式护理的成本。

Cost of informal caregiving for patients with heart failure.

作者信息

Joo Heesoo, Fang Jing, Losby Jan L, Wang Guijing

机构信息

Division for Heart Disease and Stroke Prevention, US Centers for Disease Control and Prevention (CDC), Atlanta, GA.

Division for Heart Disease and Stroke Prevention, US Centers for Disease Control and Prevention (CDC), Atlanta, GA.

出版信息

Am Heart J. 2015 Jan;169(1):142-48.e2. doi: 10.1016/j.ahj.2014.10.010. Epub 2014 Oct 25.

Abstract

BACKGROUND

Heart failure is a serious health condition that requires a significant amount of informal care. However, informal caregiving costs associated with heart failure are largely unknown.

METHODS

We used a study sample of noninstitutionalized US respondents aged ≥50 years from the 2010 HRS (n = 19,762). Heart failure cases were defined by using self-reported information. The weekly informal caregiving hours were derived by a sequence of survey questions assessing (1) whether respondents had any difficulties in activities of daily living or instrumental activities of daily living, (2) whether they had caregivers because of reported difficulties, (3) the relationship between the patient and the caregiver, (4) whether caregivers were paid, and (5) how many hours per week each informal caregiver provided help. We used a 2-part econometric model to estimate the informal caregiving hours associated with heart failure. The first part was a logit model to estimate the likelihood of using informal caregiving, and the second was a generalized linear model to estimate the amount of informal caregiving hours used among those who used informal caregiving. Replacement approach was used to estimate informal caregiving cost.

RESULTS

The 943 (3.9%) respondents who self-reported as ever being diagnosed with heart failure used about 1.6 more hours of informal caregiving per week than those who did not have heart failure (P < .001). Informal caregiving hours associated with heart failure were higher among non-Hispanic blacks (3.9 hours/week) than non-Hispanic whites (1.4 hours/week). The estimated annual informal caregiving cost attributable to heart failure was $3 billion in 2010.

CONCLUSION

The cost of informal caregiving was substantial and should be included in estimating the economic burden of heart failure. The results should help public health decision makers in understanding the economic burden of heart failure and in setting public health priorities.

摘要

背景

心力衰竭是一种严重的健康状况,需要大量的非正式护理。然而,与心力衰竭相关的非正式护理成本在很大程度上尚不明确。

方法

我们使用了来自2010年健康与退休研究(HRS)的年龄≥50岁的非机构化美国受访者的研究样本(n = 19,762)。心力衰竭病例通过自我报告信息来定义。每周的非正式护理时长由一系列调查问题得出,这些问题评估:(1)受访者在日常生活活动或工具性日常生活活动中是否有任何困难;(2)由于所报告的困难他们是否有护理者;(3)患者与护理者之间的关系;(4)护理者是否获得报酬;(5)每位非正式护理者每周提供帮助的时长。我们使用两部分计量经济模型来估计与心力衰竭相关的非正式护理时长。第一部分是一个逻辑回归模型,用于估计使用非正式护理的可能性,第二部分是一个广义线性模型,用于估计在使用非正式护理的人群中所使用的非正式护理时长。采用替代方法来估计非正式护理成本。

结果

自我报告曾被诊断为心力衰竭的943名(3.9%)受访者每周使用的非正式护理时长比未患心力衰竭的受访者多约1.6小时(P <.001)。与心力衰竭相关的非正式护理时长在非西班牙裔黑人中(每周3.9小时)高于非西班牙裔白人(每周1.4小时)。2010年,归因于心力衰竭的估计年度非正式护理成本为30亿美元。

结论

非正式护理成本巨大,应纳入心力衰竭经济负担的估计中。这些结果应有助于公共卫生决策者了解心力衰竭的经济负担并确定公共卫生优先事项。

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