title: Productivity loss and resource utilization, and associated indirect and direct costs in individuals providing care for adults with schizophrenia in the EU5.
abstract: OBJECTIVE
  This study aimed to understand the impact of providing care for adults with schizophrenia on productivity, resource utilization, and costs in the EU5 (France, Germany, Italy, Spain, and UK).
  
  
  METHODS
  Data from the 2010, 2011, and 2013 EU5 National Health and Wellness Survey, an online questionnaire of a nationwide sample of adults, were analyzed. Schizophrenia caregivers (n=398) were matched to noncaregivers (n=158,989) and other caregivers (n=14,341) via propensity scores. Outcome measures included health care utilization, Work Productivity and Activity Impairment questionnaire-based scores, and associated direct and indirect costs (estimated from the literature). Significant differences between schizophrenia caregivers vs noncaregivers and other caregivers (eg, cancer and Alzheimer's disease) were examined.
  
  
  RESULTS
  After matching, schizophrenia caregivers reported greater activity impairment (38.4% vs 26.1%), provider visits (8.0 vs 5.7), emergency room visits (0.9 vs 0.2), hospitalizations (0.8 vs 0.1), and direct costs (€2,258 vs €617) than noncaregivers, all P<0.001. Employed schizophrenia caregivers reported greater absenteeism, presenteeism, overall work impairment (35.0% vs 20.7%), and indirect costs (€6,667 vs €3,795) than noncaregivers, all P<0.001. Schizophrenia caregivers (vs other caregivers) reported greater activity impairment (38.4% vs 32.3%) and provider visits (8.0 vs 6.6), P<0.05. A greater proportion of schizophrenia caregivers (vs other caregivers) reported at least one emergency room visit (26.1% vs 20.2%) and hospitalization (20.4% vs 14.3%), P<0.05. Employed schizophrenia caregivers incurred greater indirect costs than other caregivers (€6,667 vs €5,104).
  
  
  CONCLUSIONS
  Schizophrenia caregivers reported greater activity impairment, resource utilization, and costs than noncaregivers and other caregivers. Better support systems for schizophrenia caregivers may help reduce the burden on the health care system and caregivers.
authors.affiliation: Kantar Health, Princeton, NJ, USA.
authors.forename: Shaloo
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Kantar Health, Epsom, Surrey, UK.
authors.forename: Gina
authors.initials: G
authors.lastname: Isherwood
authors.affiliation: European Federation of Associations of Families of People with Mental Illness, Diestsevest, Leuven, Belgium.
authors.forename: Kevin
authors.initials: K
authors.lastname: Jones
authors.affiliation: Janssen-Cilag GmbH, Neuss, Germany.
authors.forename: Kristel
authors.initials: K
authors.lastname: Van Impe
keywords: burden; caregiver; direct cost; emergency room; hospitalization; indirect cost; physician visits; productivity loss; resource utilization; schizophrenia