A national study of the quantity and cost of informal caregiving for the elderly with stroke.
BACKGROUND
As the US population ages, increased stroke incidence will result in higher stroke-associated costs. Although estimates of direct costs exist, little information is available regarding informal caregiving costs for stroke patients.


OBJECTIVE
To determine a nationally representative estimate of the quantity and cost of informal caregiving for stroke.


METHODS
The authors used data from the first wave of the Asset and Health Dynamics (AHEAD) Study, a longitudinal study of people over 70, to determine average weekly hours of informal caregiving. Two-part multivariable regression analyses were used to determine the likelihood of receiving informal care and the quantity of caregiving hours for those with stroke, after adjusting for important covariates. Average annual cost for informal caregiving was calculated.


RESULTS
Of 7,443 respondents, 656 (8.8%) reported a history of stroke. Of those, 375 (57%) reported stroke-related health problems (SRHP). After adjusting for cormorbid conditions, potential caregiver networks, and sociodemographics, the proportion of persons receiving informal care increased with stroke severity, and there was an association of weekly caregiving hours with stroke +/- SRHP (p < 0.01). Using the median 1999 home health aide wage (8.20 dollars/hour) as the value for family caregiver time, the expected yearly caregiving cost per stroke ranged from 3,500 dollars to 8,200 dollars. Using conservative prevalence estimates from the AHEAD sample (750,000 US elderly patients with stroke but no SRHP and 1 million with stroke and SRHP), this would result in an annual cost of up to 6.1 billion dollars for stroke-related informal caregiving in the United States.


CONCLUSIONS
Informal caregiving-associated costs are substantial and should be considered when estimating the cost of stroke treatment.
Hickenbottom
S L
SL
Department of Neurology, Consortium for Health Outcomes, Innovation, University of Michigan, Ann Arbor, USA. shickenb@umich.edu
Fendrick
A M
AM
Kutcher
J S
JS
Kabeto
M U
MU
Katz
S J
SJ
Langa
K M
KM
D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000191:economics* / Q000706:statistics & numerical data; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D020521:Stroke / Q000191:economics* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology