Department of Economics, Econometrics and Finance, Faculty of Economics and Business, University of Groningen, Nettelbosje 2, 9747 AE, Groningen, The Netherlands.
Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.
Eur J Health Econ. 2024 Nov;25(8):1311-1331. doi: 10.1007/s10198-023-01666-8. Epub 2024 Jan 31.
Faced with an unprecedented demand for long-term care, European health care systems are moving towards mixed care models, where the welfare state and informal caregivers share care responsibilities. While informal care is often viewed as a means of alleviating pressure on public care, it comes with significant economic costs for caregivers, their employers, and society at large. This study uses nationally representative data to estimate the total direct (informal care time and out-of-pocket costs) and indirect (productivity) economic costs of informal care in the Netherlands in 2019. Informal care time costs are estimated using the opportunity cost and the proxy good methods. Indirect costs are estimated using the human capital and friction cost approaches. Our results reveal the considerable annual societal cost of informal care in the Netherlands, ranging between €17.5 billion and €30.1 billion, depending on the valuation approach. These costs are equivalent to 2.15% and 3.71% of Dutch GDP in 2019, comparable to the public expenditure on long-term care in that year. Female caregivers account for slightly more than half (53%-57%) of the total costs. Around 57%-88% of these costs are in the form of informal care time. The main driver of indirect costs is the temporary cessation of work, which comprises 12%-17% of the total costs. Findings corroborate that substantial resources, yet thus far largely disregarded, are spent on informal care even in a country with a relatively generous public long-term care system.
面对前所未有的长期护理需求，欧洲医疗保健系统正在转向混合护理模式，其中福利国家和非正式护理者共同承担护理责任。虽然非正式护理通常被视为减轻公共护理压力的一种手段，但它会给护理者、他们的雇主和整个社会带来巨大的经济成本。本研究使用全国代表性数据来估计 2019 年荷兰非正式护理的总直接（非正式护理时间和自付费用）和间接（生产力）经济成本。非正式护理时间成本使用机会成本和代理商品方法进行估计。间接成本使用人力资本和摩擦成本方法进行估计。我们的研究结果揭示了荷兰非正式护理的年度社会成本相当可观，在 2019 年介于 175 亿欧元至 301 亿欧元之间，具体取决于估值方法。这些成本相当于 2019 年荷兰国内生产总值的 2.15%至 3.71%，与当年用于长期护理的公共支出相当。女性护理者占总成本的略多于一半（53%-57%）。这些成本中约有 57%-88%是以非正式护理时间的形式存在的。间接成本的主要驱动因素是临时停工，占总成本的 12%-17%。研究结果证实，即使在一个拥有相对慷慨的公共长期护理系统的国家，也会花费大量资源（尽管迄今为止这些资源在很大程度上被忽视了）用于非正式护理。
