Erasmus School of Health Policy & Management, Erasmus University Rotterdam, the Netherlands.
Erasmus School of Health Policy & Management, Erasmus University Rotterdam, the Netherlands.
Soc Sci Med. 2021 Jan;269:113562. doi: 10.1016/j.socscimed.2020.113562. Epub 2020 Dec 1.
Facing rapidly ageing populations, many Western countries aim to stimulate informal care provision as a way to meet the growing long-term care (LTC) demand. While various studies report the impact of providing informal care on the health of caregivers, it is less clear whether and to what extent this impact differs across countries. Using propensity score matching we match caregivers to similar non-caregiving individuals using four waves of the Dutch Study on Transitions in Employment, Ability and Motivation and the UK Household Longitudinal Study. The samples consist of 8129 Dutch and 7186 UK respondents, among which respectively 1711 and 1713 individuals are identified as caregivers. We explore whether the health impact of providing informal care differs by country once similar caregivers, in terms of the intensity of provided care, are compared. In both countries we find negative mental health effects of providing informal care. While these effects slightly differ by country, the main differences arise between subgroups of caregivers. Individuals that provide more than 20 hours of informal care per week, and those who face a double burden of care and full-time employment experience the most severe negative mental health effects. These results indicate that health effects of providing informal care are mediated by the specific caregiving context, allowing policymakers to use information on this context to provide targeted aid. In addition, it suggests that previously reported differences of caregiving effects across countries could be driven by differences in the population of informal caregivers which are shaped by countries' LTC policies.
面对人口迅速老龄化，许多西方国家旨在鼓励提供非正式护理，以此满足日益增长的长期护理（LTC）需求。虽然许多研究报告了提供非正式护理对护理人员健康的影响，但尚不清楚这种影响在不同国家之间是否存在差异，以及差异程度如何。我们使用倾向评分匹配，使用荷兰就业、能力和动机转型研究和英国家庭纵向研究的四轮数据，将护理人员与类似的非护理人员进行匹配。样本包括 8129 名荷兰人和 7186 名英国人，其中分别有 1711 人和 1713 人被认定为护理人员。我们探索了一旦比较了提供护理的强度相似的护理人员，提供非正式护理的健康影响是否因国家而异。在这两个国家，我们都发现提供非正式护理会对心理健康产生负面影响。虽然这些影响因国家而异，但主要差异出现在护理人员的亚组之间。每周提供超过 20 小时非正式护理的人，以及同时面临双重护理负担和全职工作的人，会经历最严重的负面心理健康影响。这些结果表明，提供非正式护理的健康影响受到特定护理环境的调节，使政策制定者能够利用有关该环境的信息提供有针对性的援助。此外，这表明之前报告的国家间护理影响差异可能是由非正式护理人员的人口差异驱动的，而这些差异是由国家的 LTC 政策形成的。
