title: Economic valuation of informal care in cerebrovascular accident survivors in Spain.
abstract: BACKGROUND
  Cerebrovascular diseases are the second leading cause of death worldwide and one of the health conditions which demand the highest level of social services. The aim of this study was to estimate the social cost of non-professional (informal) care provided to survivors of cerebrovascular accidents (CVA) with some type of disability in Spain.
  
  
  METHODS
  We obtained data from the 2008 Survey on Disability, Independent Living and Dependency (EDAD-08) on the main characteristics of individuals who provide informal care to survivors of CVAs in Spain. We estimated the cost of substituting informal care in favor of formal care provided by professional caregivers (proxy good method) and performed a statistical analysis of the relationship between degree of dependency and number of care hours provided using ordinary least squares regression.
  
  
  RESULTS
  The number of disabled people diagnosed with CVA totaled 1,975 (329,544 people when extrapolating to the national population using the elevation factor provided by EDAD-08). Of these, 1,221 individuals (192,611 people extrapolated to the national population) received at least one hour of informal care per week. The estimated hours of informal care provided in 2008 amounted to 852 million. The economic valuation of the time of informal care ranges from 6.53 billion euros (at 7.67 euros/hour) to 10.83 billion euros (when calculating each hour of care at 12.71 euros). The results of our statistical analysis highlight the importance of degree of dependency in explaining differences in the number of hours of informal care provided.
  
  
  CONCLUSIONS
  The results of our study reveal the high social cost of cerebrovascular accidents in Spain. In addition, evidence is presented of a correlation between higher degree of dependency in CVA survivors and greater number of hours of care received. An integral approach to care for CVA survivors requires that the caregivers' role and needs be taken into account.
authors.affiliation: Department of Economic and Financial Analysis, Faculty of Legal and Social Sciences, University of Castilla-La Mancha, Toledo, Spain. juan.olivamoreno@uclm.es.
authors.forename: Juan
authors.initials: J
authors.lastname: Oliva-Moreno
authors.forename: Isaac
authors.initials: I
authors.lastname: Aranda-Reneo
authors.forename: Cristina
authors.initials: C
authors.lastname: Vilaplana-Prieto
authors.forename: Almudena
authors.initials: A
authors.lastname: González-Domínguez
authors.forename: Alvaro
authors.initials: A
authors.lastname: Hidalgo-Vega
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D017028:Caregivers / Q000191:economics / Q000706:statistics & numerical data; D003625:Data Collection; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006701:Home Nursing / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000191:economics* / Q000628:therapy; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data