Shearkhani Sara, Bai Yu Qing, Kuluski Kerry, Anderson Geoffrey M, Wodchis Walter P
Michael Garron Hospital, Toronto, ON, Canada.
Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
West J Nurs Res. 2025 Mar;47(3):140-148. doi: 10.1177/01939459241310285. Epub 2024 Dec 31.
Informal caregiving is seen as a low-cost substitute for care provided by health care professionals. However, caregiving is known to negatively impact caregivers' health and, subsequently, their health care use and costs. This could potentially offset the caregivers' contributions to the health care system.
We examined the impact of caregiving on costs associated with caregivers' use of publicly funded health care services in Ontario, Canada, in comparison with non-caregivers.
We included Ontarians who participated in the Canadian Community Health Survey-Healthy Aging Supplement Survey of 2008/09 and linked responses to health care administrative databases. A difference-in-differences design was used to capture differences in caregivers' and non-caregivers' total health care costs 1 and 2 years before and after caregiving start date. Generalized Linear Models were used to model the total health care costs.
The sample size was 4275 with 1265 caregivers and 3010 non-caregivers. We found that while health care utilization increased over time, it increased by a lesser amount for caregivers than non-caregivers. Adjusted total health care costs for caregivers were 11.32% (SE = 0.05, ρ = 0.02) lower than non-caregivers 2 years into caregiving.
Our study reveals a critical gap in policy, practice, and research driven by a lack of routine data collection and caregiver identification. It also highlights the need for additional longitudinal research focusing on caregivers' objective health.
非正式照护被视为医疗保健专业人员所提供照护的低成本替代方式。然而，众所周知，照护会对照护者的健康产生负面影响，进而影响他们的医疗保健使用情况及费用。这可能会抵消照护者对医疗保健系统的贡献。
与非照护者相比，我们研究了在加拿大安大略省照护对与照护者使用公共资助医疗保健服务相关的费用的影响。
我们纳入了参与2008/09年加拿大社区健康调查——健康老龄化补充调查的安大略省居民，并将其回答与医疗保健管理数据库相链接。采用差异中的差异设计来捕捉照护开始日期前后1年和2年照护者与非照护者总医疗保健费用的差异。使用广义线性模型来模拟总医疗保健费用。
样本量为4275人，其中1265名照护者和3010名非照护者。我们发现，虽然医疗保健利用率随时间增加，但照护者的增幅小于非照护者。照护2年后，照护者经调整的总医疗保健费用比非照护者低11.32%（标准误=0.05，ρ=0.02）。
我们的研究揭示了由于缺乏常规数据收集和照护者识别，在政策、实践和研究方面存在的关键差距。它还强调了需要开展更多关注照护者客观健康状况的纵向研究。
