title: Cost of informal caregiving associated with stroke among the elderly in the United States.
abstract: OBJECTIVE
  We estimated the informal caregiving hours and costs associated with stroke.
  
  
  METHODS
  We selected persons aged 65 years and older in 2006 and who were also included in the 2008 follow-up survey from the Health and Retirement Study. We adapted the case-control study design by using self-reported occurrence of an initial stroke event during 2006 and 2008 to classify persons into the stroke (case) and the nonstroke (control) groups. We compared informal caregiving hours between case and control groups in 2006 (prestroke period for case group) and in 2008 (poststroke period for case group) and estimated incremental informal caregiving hours attributable to stroke by applying a difference-in-differences technique to propensity score-matched populations. We used a replacement approach to estimate the economic value of informal caregiving.
  
  
  RESULTS
  The weekly incremental informal caregiving hours attributable to stroke were 8.5 hours per patient. The economic value of informal caregiving per stroke survivor was $8,211 per year, of which $4,356 (53%) was attributable to stroke. At the national level, the annual economic burden of informal caregiving associated with stroke among elderly was estimated at $14.2 billion in 2008.
  
  
  CONCLUSIONS
  Recent changes in public health and social support policies recognize the economic burden of informal caregiving. Our estimates reinforce the high economic burden of stroke in the United States and provide up-to-date information for policy development and decision-making.
authors.affiliation: From the US Centers for Disease Control and Prevention, Atlanta, GA. hj528176@gmail.com.
authors.forename: Heesoo
authors.initials: H
authors.lastname: Joo
authors.affiliation: From the US Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Diane O
authors.initials: DO
authors.lastname: Dunet
authors.affiliation: From the US Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Jing
authors.initials: J
authors.lastname: Fang
authors.affiliation: From the US Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Guijing
authors.initials: G
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D017028:Caregivers / Q000191:economics* / Q000523:psychology; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012189:Retrospective Studies; D012944:Social Support; D020521:Stroke / Q000191:economics* / Q000453:epidemiology / Q000451:nursing*; D014481:United States / Q000453:epidemiology