Nortey Stephen Tettey, Aryeetey Genevieve Cecilia, Aikins Moses, Amendah Djesika, Nonvignon Justice
Sinel Specialist Hospital, Tema, Ghana.
Department of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana.
Int J Equity Health. 2017 Jan 14;16(1):16. doi: 10.1186/s12939-016-0511-9.
Health systems in low and lower-middle income countries, particularly in sub-Sahara Africa, often lack the specialized personnel and infrastructure to provide comprehensive care for elderly/ageing populations. Close-to-client community-based approaches are a low-cost way of providing basic care and social support for elderly populations in such resource-constrained settings and family caregivers play a crucial role in that regard. However, family caregiving duties are often unremunerated and their care-related economic burden is often overlooked though this knowledge is important in designing or scaling up effective interventions. The objective of this study, therefore, was to estimate the economic burden of family caregiving for the elderly in southern Ghana.
The study was a retrospective cross-sectional cost-of-care study conducted in 2015 among family caregivers for elderly registered for a support group in a peri-urban district in southern Ghana. A simple random sample of 98 respondents representative of the support group members completed an interviewer-administered questionnaire. Costs were assessed over a 1-month period. Direct costs of caregiving (including out-of-pocket costs incurred on health care) as well as productivity losses (i.e. indirect cost) to caregivers were analysed. Intangible costs were assessed using the 12-item Zarit burden interview (ZBI) tool and the financial cost dimension of the cost of care index.
The estimated average cost of caregiving per month was US$186.18, 66% of which was direct cost. About 78% of the family caregivers in the study reported a high level of caregiving burden (as measured with the ZBI) with females reporting a relatively higher level than males. Further, about 87% of the family caregivers reported a high level of financial stress as a result of caregiving for their elderly relative.
The study shows that support/caregiving for elderly populations imposes economic burden on families, potentially influencing the economic position of families with attendant implications for equity and future family support for such vulnerable populations.
低收入和中低收入国家的卫生系统，尤其是撒哈拉以南非洲地区的卫生系统，往往缺乏为老年/老龄人口提供全面护理的专业人员和基础设施。在资源有限的环境中，以社区为基础的贴近客户的方法是为老年人口提供基本护理和社会支持的低成本方式，家庭照顾者在这方面发挥着关键作用。然而，家庭照顾工作往往没有报酬，其与照顾相关的经济负担常常被忽视，尽管这一认识对于设计或扩大有效的干预措施很重要。因此，本研究的目的是估计加纳南部家庭照顾老年人的经济负担。
该研究是一项回顾性横断面护理成本研究，于2015年在加纳南部一个城郊地区为一个支持小组登记的老年家庭照顾者中进行。从支持小组成员中随机抽取98名具有代表性的受访者，完成一份由访谈员管理的问卷。成本评估为期1个月。分析了照顾的直接成本（包括医疗保健方面的自付费用）以及照顾者的生产力损失（即间接成本）。使用12项 Zarit负担访谈（ZBI）工具和护理成本指数的财务成本维度评估无形成本。
估计每月照顾的平均成本为186.18美元，其中66%为直接成本。在该研究中，约78%的家庭照顾者报告了高水平的照顾负担（用ZBI衡量），女性报告的水平相对高于男性。此外，约87%的家庭照顾者报告，由于照顾老年亲属而承受着高水平的经济压力。
该研究表明，对老年人口的支持/照顾给家庭带来了经济负担，可能影响家庭的经济状况，对公平性以及未来家庭对这类弱势群体的支持产生影响。
