Institute for Clinical Effectiveness and Health Policy (IECS), C1414CPV, Ciudad de Buenos Aires, Argentina.
National Council for Scientific and Technical Research (CONICET), Buenos Aires, Argentina.
BMC Public Health. 2023 Jan 5;23(1):28. doi: 10.1186/s12889-022-14835-w.
Informal care is a key element of health care and well-being for society, yet it is scarcely visible and rarely studied in health economic evaluations. This study aims to estimate the time use and cost associated with informal care for cardiovascular diseases, pneumonia and ten different cancers in eight Latin American countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Mexico and Peru).
We carried out an exhaustive literature review on informal caregivers' time use, focusing on the selected diseases. We developed a survey for professional caregivers and conducted expert interviews to validate this data in the local context. We used an indirect estimate through the interpolation of the available data, for those cases in which we do not found reliable information. We used the proxy good method to estimate the monetary value of the use of time of informal care. National household surveys databases were processed to obtain the average wage per hour of a proxy of informal caregiver. Estimates were expressed in 2020 US dollars.
The study estimated approximately 1,900 million hours of informal care annually and $ 4,300 million per year in average informal care time cost for these fifteen diseases and eight countries analyzed. Cardiovascular diseases accounted for an informal care burden that ranged from 374 to 555 h per year, while cancers varied from 512 to 1,825 h per year. The informal care time cost share on GDP varied from 0.26% (Mexico) to 1.38% (Brazil), with an average of 0.82% in the studied American countries. Informal care time cost represents between 16 and 44% of the total economic cost (direct medical and informal care cost) associated with health conditions.
The study shows that there is a significant informal care economic burden -frequently overlooked- in different chronic and acute diseases in Latin American countries; and highlights the relevance of including the economic value of informal care in economic evaluations of healthcare.
非正规护理是社会医疗保健和福祉的关键组成部分，但在卫生经济评估中几乎看不见，也很少研究。本研究旨在估计 8 个拉丁美洲国家（阿根廷、巴西、智利、哥伦比亚、哥斯达黎加、厄瓜多尔、墨西哥和秘鲁）中与心血管疾病、肺炎和 10 种不同癌症相关的非正规护理的时间使用和成本。
我们对非正规护理人员的时间使用进行了全面的文献回顾，重点关注选定的疾病。我们为专业护理人员开发了一项调查，并进行了专家访谈，以验证该数据在当地背景下的有效性。对于那些我们没有找到可靠信息的情况，我们通过插值可用数据进行间接估计。我们使用代理商品法来估计非正规护理时间使用的货币价值。处理国家家庭调查数据库以获得非正规护理代理每小时的平均工资。估计值以 2020 年美元表示。
该研究估计，在这 8 个国家和 15 种疾病中，每年需要约 19 亿小时的非正规护理，每年的非正规护理时间成本平均为 43 亿美元。心血管疾病的非正规护理负担每年在 374 至 555 小时之间，而癌症每年在 512 至 1825 小时之间。非正规护理时间成本占 GDP 的份额从墨西哥的 0.26%到巴西的 1.38%不等，在所研究的美洲国家中平均为 0.82%。非正规护理时间成本占与健康状况相关的总经济成本（直接医疗和非正规护理成本）的 16%至 44%。
该研究表明，在拉丁美洲国家的不同慢性和急性疾病中，存在着大量被忽视的非正规护理经济负担；并强调了在医疗保健经济评估中纳入非正规护理经济价值的重要性。
