Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia.
Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia.
Value Health. 2021 Dec;24(12):1863-1870. doi: 10.1016/j.jval.2021.04.1283. Epub 2021 Aug 2.
This study aimed to identify the methods used to determine the value of informal care provided to people living with dementia and to estimate the average hourly unit cost by valuation method.
A literature search in MEDLINE Complete, CINAHL, PsycINFO, EconLit, EMBASE and NHS Economic Evaluation Database was undertaken. Following the screening of title, abstract, and full text, characteristics of eligible studies were extracted systematically and analyzed descriptively. The corresponding hourly cost estimates were converted into 2018 US dollars based on purchasing power parities for gross domestic product.
A total number of 111 articles were included in this review from 3106 post-deduplication records. Three main valuation methodologies were identified: the replacement cost method (n = 50), the opportunity cost approach (n = 36), and the stated preference method based on willingness to pay (n = 3), with 16 studies using multiple methods and 6 studies not specifying the valuation method. The amount of informal care increased as the condition of dementia progressed, which was reflected in the cost of informal care. The average hourly unit cost used to value informal care was US $16.78 (SD = US $12.11). Although the unit cost was approximately US $15 per hour when using the opportunity cost method and US $14 when using the stated preference method, the highest unit cost was obtained when using the replacement cost method (US $18.37, SD = US $13.12).
Although costs of informal care should be considered when undertaking an economic evaluation or estimating the overall costs of dementia from a policy and priority-setting perspective, further research into applying consistent approaches to valuation is warranted.
本研究旨在确定用于确定为患有痴呆症的人提供的非正规护理价值的方法，并按估值方法估算平均每小时单位成本。
对 MEDLINE Complete、CINAHL、PsycINFO、EconLit、EMBASE 和 NHS 经济评估数据库进行文献检索。在筛选标题、摘要和全文后，系统地提取合格研究的特征并进行描述性分析。根据国内生产总值的购买力平价，将相应的每小时成本估算转换为 2018 年美元。
从 3106 条去重记录中，共纳入 111 篇文章。确定了三种主要的估值方法：重置成本法（n=50）、机会成本法（n=36）和基于意愿支付的陈述偏好法（n=3），其中 16 项研究使用了多种方法，6 项研究未指定估值方法。随着痴呆症病情的发展，非正规护理的数量增加，这反映在非正规护理的成本上。用于评估非正规护理的平均每小时单位成本为 16.78 美元（SD=12.11 美元）。虽然使用机会成本法时每小时单位成本约为 15 美元，使用陈述偏好法时为 14 美元，但使用重置成本法时获得的单位成本最高（18.37 美元，SD=13.12 美元）。
尽管从经济评估或从政策和优先事项设定角度估算痴呆症的总体成本时应考虑非正规护理的成本，但有必要进一步研究应用一致的估值方法。
