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临终时对癌症逝者非正式护理的货币估值:来自全国人口普查调查的证据。

The monetary valuation of informal care to cancer decedents at end-of-life: Evidence from a national census survey.

作者信息

Urwin Sean, Van den Berg Bernard, Lau Yiu-Shing, Rowland Christine, Hanratty Barbara, Grande Gunn

机构信息

School of Health Sciences, University of Manchester, Manchester, UK.

Department of Health Sciences, VU University Amsterdam, Amsterdam, The Netherlands.

出版信息

Palliat Med. 2021 Apr;35(4):750-758. doi: 10.1177/0269216321989569. Epub 2021 Jan 21.

Abstract

BACKGROUND

Carers' end-of-life caregiving greatly benefits society but little is known about the monetary value of this care.

AIM

Within an end-of-life cancer setting: (1) to assess the feasibility and content validity of a post-bereavement measure of hours of care; and (2) to obtain a monetary value of this informal care and identify variation in this value among sub-groups.

DESIGN AND SETTING

A census based cross-sectional survey of all cancer deaths from a 2-week period in England collected detailed data on caregiving activity (10 caregiving tasks and the time spent on each). We descriptively analyse the information carers provided in 'other' tasks to inform content validity. We assigned a monetary value of caregiving via the proxy good method and examined variation in the value via regression analysis.

RESULTS

The majority of carers (89.9%) were able to complete the detailed questions about hours and tasks. Only 153 carers reported engaging in 'other' tasks. The monetary value of caregiving at end-of-life was £948.86 per week with social and emotional support and symptom management tasks representing the largest proportion of this monetary valuation. Time of recall did not substantially relate to variation in the monetary value, whereas there was a stronger association for the relationship between the carer and recipient, carer gender and recipient daily living restrictions.

CONCLUSION

The monetary valuation we produce for carers' work is substantial, for example the weekly UK Carers' Allowance only amounts to 7% of our estimated value of £948.86 per week. Our research provides further information on subgroup variation, and a valid carer time instrument and method to inform economic evaluation and policy.

摘要

背景

照顾者在临终阶段提供的护理对社会有极大益处,但这种护理的货币价值却鲜为人知。

目的

在临终癌症患者的背景下:(1)评估丧亲后护理时长测量方法的可行性和内容效度;(2)得出这种非正式护理的货币价值,并确定亚组间该价值的差异。

设计与设置

基于普查的横断面调查,收集了英格兰某两周内所有癌症死亡病例的详细护理活动数据(10项护理任务及每项任务所花费的时间)。我们对照顾者在“其他”任务中提供的信息进行描述性分析,以了解内容效度。我们通过替代商品法赋予护理货币价值,并通过回归分析研究该价值的差异。

结果

大多数照顾者(89.9%)能够完成关于时长和任务的详细问题。只有153名照顾者报告参与了“其他”任务。临终护理的货币价值为每周948.86英镑,其中社会和情感支持以及症状管理任务在这一货币估值中占比最大。回忆时间与货币价值的差异没有显著关联,而照顾者与接受者的关系、照顾者性别和接受者日常生活受限程度之间的关联更强。

结论

我们得出的照顾者工作的货币估值相当可观,例如英国每周的照顾者津贴仅为我们估计的每周948.86英镑价值的7%。我们的研究提供了关于亚组差异的更多信息,以及一种有效的照顾者时间测量工具和方法,为经济评估和政策提供参考。

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The cost of cancer in Europe 2018.《2018 年欧洲癌症成本》
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