Article Abstract

Article Abstract

Online ISSN: 1099-176X Print ISSN: 1091-4358
The Journal of Mental Health Policy and Economics
Volume 13, Issue 3, 2010. Pages: 127-133
Published Online: 30 September 2010

The Value of Informal Caregiver Time for Psychotic Illness

Catharina Hjortsberg¹* and Ulf Persson^1,2

¹PhD, The Swedish Institute for Health Economics, Lund, Sweden.
²PhD, The Swedish Institute for Health Economics and Lund Institute of Economic Research, Lund University, Lund, Sweden.

* Correspondence to: Catharina Hjortsberg, The Swedish Institute for Health Economics, P.O. Box 2127, SE-220 02 Lund, Sweden.
Tel.: +46-46-329 100
Fax: +46-46-121 604
E-mail: ch@ihe.se

Source of Funding: This study was supported by an unrestricted grant from Janssen-Cilag AB, Sweden.

Abstract

Psychotic illness can have a substantial economic burden on family members providing informal care. While informal care is unpaid, it is not free in an economic sense since time spent providing care cannot be directed to other activities such as paid work or leisure. Literature on the costs of informal care and leisure time are used to discuss alternative methods for valuing caregiver time.We suggest that when the caregiver is taking time from work to perform care tasks, informal care should be valued by the opportunity cost approach by applying wages paid by the employer. When the caregiver is taking time from her or his leisure time, we suggest that an hour of informal care should be valued by the individual’s income loss (net income). One conclusion is that the value of informal care will be context specific and estimates are difficult to generalise from country to country.

Background: Psychotic illness can have a substantial economic burden not only on the patient and society in general, but also on family members providing informal care (i.e. those not subject to a market wage). While informal caregiving confers benefits for the patient and society, time spent providing informal care is diverted from other activities such as work or leisure. Relatives and caregivers experience burden both on a practical and an emotional level. Informal caregiving has often gone unrecognised in public policy discussions about the financing and costs of health care.

Aim: The aim of this paper is to provide suggestions for valuing caregiver time for psychotic illness.

Materials and Methods Literature on the costs of informal care and the cost of leisure time, is used to discuss possibilities for estimating the value of informal care.

Results: The monetary value of informal care depends on income levels both for those who give up paid work and for those who forego leisure time. Estimates are thus context dependent and might be difficult to generalise.

Discussion: Informal care is a substantial part of total patient care, especially for chronic illness. The support of family caregivers for patients with mental illnesses often has an important impact on the general well-being of the patient. Because it is typically unpaid, informal care has been seen as a low cost, even costless, substitute for formal care. Placing a value on the hours of care provided by informal caregivers for patients suffering from mental illnesses is necessary if one wants to provide an accurate picture of the costs associated with the diseases. Time spent on informal care has a value and methods of estimating costs of informal care are available.

Implications for Health Care Provision and Use: Cost studies should take account of the cost of informal care, as ignoring informal care means that it is viewed as a costless substitute for formal care. While informal care is unpaid, it is not free in an economic sense since time spent providing care cannot be directed to other activities such as paid work or leisure. From a societal perspective, not accounting for informal care may lead to a poor allocation of resources and a disregard of the effect of informal care on the health and well-being of caregivers. Cost of informal care constitutes a sizeable proportion of total costs and should not be neglected.

Received 13 November 2009; accepted 26 August 2010