title: Valuing care recipient and family caregiver time: a comparison of methods.
abstract: OBJECTIVE
  The purpose of this study is to compare the approaches used for valuing family caregiver and care recipient time devoted to providing and receiving care.
  
  
  METHODS
  Valuation approaches were operationalized within a cohort of cystic fibrosis care recipients (n = 110). Base-case analyses, grounded in human capital theory, applied earnings estimates to caregiving time to impute the market value of time lost from labor. Unpaid labor and leisure time was valued with a replacement cost (homemaker's wage rate). Total time costs were computed and sensitivity analyses were conducted to describe the effects of alternative valuation methods on total costs.
  
  
  RESULTS
  The mean time cost per care recipient-caregiver dyad over 28 days was $2,026CAD. The majority (76 percent) of time costs were due to losses from unpaid labor and leisure time. Varying the valuation of paid labor time did not result in significantly different total time costs (p = .0877). However, varying the method of valuing unpaid labor and leisure time did significantly affect total costs (p < .0001).
  
  
  CONCLUSIONS
  Care recipients and caregivers primarily lost time from unpaid labor and leisure in the treatment of cystic fibrosis. Moreover, when the above losses were aggregated, the method of valuation greatly influenced overall results. The findings clearly indicate that omitting caregiver and unpaid labor and leisure costs may result in an inaccurate assessment of ambulatory and home-based healthcare programs.
authors.affiliation: Assistant Professor, Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. denise.guerriere@utoronto.ca
authors.forename: Denise N
authors.initials: DN
authors.lastname: Guerriere
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Tranmer
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Ungar
authors.forename: Venika
authors.initials: V
authors.lastname: Manoharan
authors.forename: Peter C
authors.initials: PC
authors.lastname: Coyte
mesh_terms: D000328:Adult; D017028:Caregivers / Q000191:economics*; D003365:Costs and Cost Analysis / Q000379:methods; D003550:Cystic Fibrosis; D005260:Female; D006801:Humans; D008297:Male; D009864:Ontario; D011795:Surveys and Questionnaires; D013997:Time Factors