The fiscal impact of informal caregiving to home care recipients in Canada: how the intensity of care influences costs and benefits to government.
The objective of this study was to estimate the annual costs and consequences of unpaid caregiving by Canadians from a government perspective. We estimated these costs both at the individual and population levels for caregivers aged 45 and older. We conducted a cost-benefit analysis where we considered the costs of unpaid caregiving to be potential losses in income tax revenues and changes in social assistance payments and the potential benefit of reduced paid care expenditures. Our costing methods were based on multivariate analyses using the 2007 General Social Survey, a cross-sectional survey of 23,404 individuals. We determined the differential probability of employment, wages, and hours worked by caregivers of varying intensity versus non-caregivers. We also used multivariate analysis to determine how receiving different intensities of unpaid care impacted both the probability of receiving paid care and the weekly hours of paid care received. At the lowest intensities of caregiving, there was a net benefit to government from caregiving, at both the individual and population levels. At the population level, the net benefit to government was estimated to be $4.4 billion for caregivers providing less than five hours of weekly care. At the highest intensity of caregiving, there was a net cost to government of $641 million. Our overall findings were robust to a number of changes applied in our sensitivity analysis. We found that the factor with the greatest impact on cost was the probability of labour force participation. As the biggest cost driver appears to be the higher likelihood of intense caregivers dropping out of the labour force, government policies that enable intense caregivers to balance caregiving with employment may help to mitigate these losses.
Institute of Health Policy, Management, and Evaluation, University of Toronto, 155 College St., Toronto, Canada M5T 3M6. jo.jacobs@mail.utoronto.ca
Josephine C
JC
Jacobs
Meredith B
MB
Lilly
Carita
C
Ng
Peter C
PC
Coyte
D002170:Canada; D017028:Caregivers / Q000191:economics* / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D004651:Employment / Q000191:economics; D035082:Federal Government; D005260:Female; D006701:Home Nursing / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007183:Income Tax / Q000191:economics; D008297:Male; D008875:Middle Aged; D012946:Social Welfare / Q000191:economics; D013997:Time Factors