Estimating the cost of informal caregiving for elderly patients with cancer.
OBJECTIVE
As the United States population ages, the increasing prevalence of cancer is likely to result in higher direct medical and nonmedical costs. Although estimates of the associated direct medical costs exist, very little information is available regarding the prevalence, time, and cost associated with informal caregiving for elderly cancer patients.


METHODS
To estimate these costs, we used data from the first wave (1993) of the Asset and Health Dynamics (AHEAD) Study, a nationally representative longitudinal survey of people aged 70 or older. Using a multivariable, two-part regression model to control for differences in health and functional status, social support, and sociodemographics, we estimated the probability of receiving informal care, the average weekly number of caregiving hours, and the average annual caregiving cost per case (assuming an average hourly wage of $8.17) for subjects who reported no history of cancer (NC), having a diagnosis of cancer but not receiving treatment for their cancer in the last year (CNT), and having a diagnosis of cancer and receiving treatment in the last year (CT).


RESULTS
Of the 7,443 subjects surveyed, 6,422 (86%) reported NC, 718 (10%) reported CNT, and 303 (4%) reported CT. Whereas the adjusted probability of informal caregiving for those respondents reporting NC and CNT was 26%, it was 34% for those reporting CT (P <.05). Those subjects reporting CT received an average of 10.0 hours of informal caregiving per week, as compared with 6.9 and 6.8 hours for those who reported NC and CNT, respectively (P <.05). Accordingly, cancer treatment was associated with an incremental increase of 3.1 hours per week, which translates into an additional average yearly cost of $1,200 per patient and just over $1 billion nationally.


CONCLUSIONS
Informal caregiving costs are substantial and should be considered when estimating the cost of cancer treatment in the elderly.
Hayman
J A
JA
Department of Radiation Oncology, University of Michigan, Ann Arbor, 48109, USA. hayman@umich.edu.
Langa
K M
KM
Kabeto
M U
MU
Katz
S J
SJ
DeMonner
S M
SM
Chernew
M E
ME
Slavin
M B
MB
Fendrick
A M
AM
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000191:economics* / Q000706:statistics & numerical data; D017281:Cost of Illness; D005190:Family / Q000523:psychology; D005260:Female; D006701:Home Nursing / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009369:Neoplasms / Q000150:complications / Q000191:economics* / Q000628:therapy*; D012044:Regression Analysis; D014481:United States