IHRC Inc., Atlanta, Georgia; Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
Am J Prev Med. 2017 Dec;53(6S2):S197-S204. doi: 10.1016/j.amepre.2017.07.020.
Older adults are at high risk for stroke and falls, both of which require a large amount of informal caregiving. However, the economic burden of informal caregiving associated with stroke and fall history is not well known.
Using the 2010 Health and Retirement Study, data on non-institutionalized adults aged ≥65 years (N=10,129) in 2015-2017 were analyzed. Two-part models were used to estimate informal caregiving hours. Based on estimates from the models using a replacement cost approach, the authors derived informal caregiving hours and costs associated with falls in the past 2 years for stroke and non-stroke persons.
Both the prevalence of falls overall and of falls with injuries were higher among people with stroke than those without (49.5% vs 35.1% for falls and 16.0% vs 10.3% for injurious falls, p<0.01). Stroke survivors needed more informal caregiving hours than their non-stroke counterparts, and the number of informal caregiving hours was positively associated with non-injurious falls and even more so with injurious falls. The national burden of informal caregiving (2015 U.S. dollars) associated with injurious falls amounted to $2.9 billion (95% CI=$1.1 billion, $4.7 billion) for stroke survivors (about 0.5 million people), and $6.5 billion (95% CI=$4.3 billion, $8.7 billion) for those who never had a stroke (about 3.6 million people).
In U.S. older adults, informal caregiving hours and costs associated with falls are substantial, especially for stroke survivors. Preventing falls and fall-related injuries, especially among stroke survivors, therefore has potential for reducing the burden of informal caregiving.
老年人中风和跌倒的风险较高，这两种情况都需要大量的非正规护理。然而，与中风和跌倒史相关的非正规护理的经济负担尚不清楚。
利用 2010 年健康与退休研究的数据，对 2015-2017 年年龄在 65 岁及以上的非机构化成年人（N=10129）进行了分析。使用两部分模型来估计非正规护理时间。根据使用替代成本方法的模型估计，作者得出了过去 2 年内与中风和非中风患者跌倒相关的非正规护理时间和成本。
总体而言，中风患者跌倒的发生率和受伤跌倒的发生率均高于非中风患者（49.5%对 35.1%的跌倒和 16.0%对 10.3%的受伤跌倒，p<0.01）。中风幸存者需要比非中风幸存者更多的非正规护理时间，而且非正规护理时间的数量与非受伤跌倒呈正相关，与受伤跌倒更是如此。与受伤跌倒相关的非正规护理的国家负担（2015 年美元）为中风幸存者 29 亿美元（95%CI=11 亿至 47 亿美元）（约 50 万人），从未中风者 65 亿美元（95%CI=43 亿至 87 亿美元）（约 360 万人）。
在美国老年人中，与跌倒相关的非正规护理时间和成本相当大，尤其是对于中风幸存者。因此，预防跌倒和与跌倒相关的伤害，尤其是在中风幸存者中，有可能减轻非正规护理的负担。
