School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
Policy and Epidemiology Group, Queensland Centre for Mental Health Research, The Park-Centre for Mental Health, Locked Bag 500, Archerfield, QLD, 4108, Australia.
Soc Psychiatry Psychiatr Epidemiol. 2021 Mar;56(3):387-400. doi: 10.1007/s00127-020-01868-y. Epub 2020 Apr 15.
To quantify and value the total informal support provided by family and friends to Australian adults with mental illness in 2018.
The number of mental health carers was drawn from the 2015 Survey of Disability, Ageing and Carers (SDAC), adjusted to the 2018 population. Annual caring hours by type of assistance were estimated using the SDAC, 2007 National Survey of Mental Health and Wellbeing and an online carer survey. Caring hours for each task were assigned an hourly replacement cost from the National Disability Insurance Scheme. Informal caring was valued as the sum of these costs minus expenditure on carer income support payments, estimating how much it would hypothetically cost governments to replace this care with formal support services.
An estimated 354,000 (95% uncertainty interval (UI): 327,000-383,000) Australian mental health carers provided 186 million (95% UI: 159-215) hours of support in 2018. The estimated replacement cost was AU$8.4 billion (95% UI: 7.0-10.0), excluding AU$1.3 billion in income support. Univariate sensitivity analyses demonstrated that results were robust to variation in model inputs, with total caring hours the most influential parameter. Using an alternative estimate of mean caring hours, the replacement cost could be as high as AU$13.2 billion (95% UI: 11.2-15.4).
Informal carers provide substantial support to people with mental illness, highlighting their important contribution to the mental health system and reinforcing the need for carer support services. Future valuation studies would benefit from refinement of available data collections, particularly on hours and types of care provided.
量化和评估 2018 年澳大利亚有精神疾病的成年人所获得的来自家人和朋友的非正式支持的总量。
精神健康护理员的数量来自 2015 年残疾、老龄化和护理员调查（SDAC），并根据 2018 年的人口进行了调整。通过 SDAC、2007 年全国精神健康和福利调查以及在线护理员调查，对每种类型的援助的年度护理时间进行了估计。为每项任务分配的护理时间乘以国家残疾保险计划的每小时替代成本。将非正式护理视为这些成本减去护理收入支持付款支出的总和，以估算政府用正规支持服务替代这种护理的成本。
估计有 35.4 万（95%不确定性区间（UI）：32.7 万-38.3 万）名澳大利亚精神健康护理员在 2018 年提供了 1.86 亿（95% UI：1.59 亿-2.15 亿）小时的支持。估计的替代成本为 84 亿澳元（95% UI：7.0-10.0），不包括 13 亿澳元的收入支持。单变量敏感性分析表明，结果对模型输入的变化具有稳健性，总护理时间是最具影响力的参数。使用替代的平均护理时间估计，替代成本可能高达 132 亿澳元（95% UI：11.2-15.4）。
非正式护理员为有精神疾病的人提供了大量支持，突出了他们对精神卫生系统的重要贡献，并重申了对护理员支持服务的需求。未来的估值研究将受益于对现有数据收集的改进，特别是在提供的护理时间和类型方面。
