Skip to main content

Advertisement

SpringerLink
Log in

In pursuit of QALY weights for relatives: empirical estimates in relatives caring for older people

  • Original paper
  • Published:
The European Journal of Health Economics Aims and scope Submit manuscript

Abstract

This study estimates quality-adjusted life-year (QALY) weights for relatives caring for an older person. The data used are from the Swedish part of the EUROFAMCARE study. A new measure is introduced called the R-QALY weight, defined as the effect on a relative’s QALY weight due to being a relative of a disabled or sick individual. R-QALY weights were created by comparing relatives’ QALY weights with population-based QALY weights. They were also created by comparing with QALY weights reassessed for a hypothetical situation in which the older person needed no care. The results indicate that R-QALY weights are small when compared with population-based weights, but large when compared with QALY weights reassessed for the hypothetical situation. Moreover, R-QALY weights were affected by relatives’ age, sex, and subjective perception of positive and negative aspects of the caregiving situation. These aspects should therefore be taken into account in health economics evaluations using a societal approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Gold, M.R., Siegel, J.E., Russel, L.B., Weinstein, M.C.: Cost-effectiveness in health, medicine. Oxford University Press, New York (1996)

    Google Scholar 

  2. Drummond, M.F., O’Brian, B., Stoddart, G.L., Torrance, G.W.: Methods for the economic evaluation of health care programmes. 2nd edn. Oxford University Press, New York (1997)

    Google Scholar 

  3. Torrance, G.W., Siegel, J.E., Luce, B.R.: Framing, designing the cost-effectiveness analysis. In: Gold, M.R., Siegel, J.E., Russel, L.B., Weinstein, M.C. (eds.) Cost-effectiveness in health and medicine. Oxford University Press, NewYork (1996)

    Google Scholar 

  4. Basu, A., Meltzer, D.: Implications of spillover effects within the family for medical cost-effectiveness analysis. J. Health Econ. 24, 751–773 (2005)

    Article  Google Scholar 

  5. Brouwer, W., Van Exel, N., Van Gorp, B., Redekop, W.: The CarerQol instrument: a new instrument to measure care-related quality of life of informal caregivers for use in economic evaluations. Qual. Life Res. 15, 1005–1021 (2006)

    Article  Google Scholar 

  6. Dixon, S., Walker, M., Salek, S.: Incorporating carer effects into economic evaluation. Pharmacoeconomics 24, 43–53 (2006)

    Article  Google Scholar 

  7. Mohide, E.A., Torrance, G.W., Streiner, D.L., Pringle, D.M., Gilbert, J.R.: Measuring the wellbeing of family caregivers using the time trade-off technique. J. Clin. Epidemiol. 41, 475–482 (1988)

    Article  Google Scholar 

  8. Brouwer, W.B., Van Exel, N.J.A., Koopmanschap, M.A., Rutten, F.F.H.: The valuation of informal care in economic appraisal. A consideration of individual choice and societal costs of time. Int. J. Technol. Assess. Health Care 15, 147–160 (1999)

    Article  Google Scholar 

  9. Sundström, G., Johansson, L., Hassing, L.: The shifting balance of long-term care in Sweden. Gerontologist 42, 350–355 (2002)

    Google Scholar 

  10. Khaw, K.T.: How many, how old, how soon? BMJ 319, 1350–1352 (1999)

    Google Scholar 

  11. Kristensson Ekwall, A.: Informal caregiving at old age—content, coping difficulties and satisfaction, PhD dissertation, Lund University (2004)

  12. Stolz, P., Udén, G., Willman, A.: Support for family carers who care for an elderly person at home—systematic review. Scand. J. Caring Sci. 18, 111–119 (2004)

    Article  Google Scholar 

  13. Schulz, R., Martire, L.M.: Family caregiving of persons with dementia. Am. J. Geriatr. Psychiatry 12, 240–249 (2004)

    Article  Google Scholar 

  14. Whitlatch, C.J.: Distress and burden for family caregivers. In: Wimo, A., Jönsson, B., Karlsson, G., Winblad, B. (eds.) Health Economics of Dementia. Wiley, Chichester (1998)

    Google Scholar 

  15. Argimon, J.M., Limon, E., Vila, J., Cabezas, C.: Health-related quality of life in carers of patients with dementia. Fam. Pract. 21, 454–457 (2004)

    Article  Google Scholar 

  16. Aneshensel, C.S., Pearlin, L.I., Schuler, R.H.: Stress, role captivity, and the cessation of caregiving. J. Health Soc. Behav. 34, 54–70 (1993)

    Article  Google Scholar 

  17. White, C.L., Lauzon, S., Yaffe, M.J.: Wood-Dauphinee, S. Toward a model of quality of life for family caregivers of stroke survivors. Qual. Life Res. 13, 625–638 (2004)

    Article  Google Scholar 

  18. EUROFAMCARE Services for supporting family carers of elderly people in Europe: characteristics, coverage and usage. Available from: http://www.uke.uni-hamburg.de/extern/eurofamcare (Accessed 28 Sept. 2006)

  19. Brooks, R.: EuroQol: the current state of play. Health Policy 37, 53–72 (1996)

    Article  Google Scholar 

  20. Dolan, P.: Modeling valuations for EuroQol health states. Med. Care 35, 1095–1098 (1997)

    Article  Google Scholar 

  21. Burström, K., Johannesson, M., Diderichsen, F.: Swedish population health-related quality of life results using the EQ-5D. Qual. Life Res. 10, 621–635 (2001)

    Article  Google Scholar 

  22. McKee, K.J., Philp, I., Lamura, G., et al.: The COPE Index: a first stage assessment of negative impact, positive value and quality of support of caregiving in informal carers of older people. Aging Ment. Health 7, 39–52 (2003)

    Article  Google Scholar 

  23. McKee, K., Balducci, C., Krevers, B. et.al. TEUSURE Chapter 3: The EUROFAMCARE common assessment tool (CAT): item and scale development and description. In: Doehner, H. Kofahl, C. (eds.) Supporting Services for Family Carers of Older People in Europe: Trans-European Report of the 6-country EUROFAMCARE survey, Hamburg University (2006)

  24. Brouwer, W.B., Van Exel, N.J.A., Van den Berg, B., et al.: Burden of caregiving: evidence of objective burden, subjective burden, and quality of life impacts on informal caregivers of patients with rheumatoid arthritis. Arthritis Rheum. 51, 570–577 (2004)

    Article  Google Scholar 

  25. Mulvaney-Day, N.E.: Using willingness to pay to measure family members’ preferences in mental health. J. Ment. Health Policy Econ. 8, 71–81 (2005)

    Google Scholar 

  26. Donaldson, C., Tarrier, N., Burns, A.: Determinants of carer stress in Alzheimer’s disease. Int. J. Geriatr. Psychiatry 13, 248–256 (1998)

    Article  Google Scholar 

  27. Öberg, B., Quattrini, S., Brown, J.,et.al.: TEUSURE Chapter 4: Sampling, recruitment and representativeness. In: Doehner, H., Kofahl, C. (eds.) Supporting Services for Family Carers of Older People in Europe: Trans-European Report of the 6-country EUROFAMCARE survey, Hamburg University (2006)

  28. Rajagopalan, K., Abetz, L., Mertzanis, P., et al.: Comparing the discriminative validity of two generic and one disease-specific health-related quality of life measures in a sample of patients with dry eye. Value Health 8, 168–174 (2005)

    Article  Google Scholar 

  29. Brouwer, W.B., Van Exel, N.J.A., Van den Berg, B., Van den Bos, G.A.M., Koopmanschap, M.A.: Process utility from providing informal care: the benefit of caring. Health Policy 74, 85–99 (2005)

    Article  Google Scholar 

  30. Hawthorne, G.: The effect of different methods of collecting data: mail, telephone and filter data collection issues in utility measurement. Qual. Life Res. 12, 1081–1088 (2003)

    Article  Google Scholar 

  31. Arrow, K.A.: Difficulty in the concept of social welfare. J. Polit. Econ. 58, 328–346 (1950)

    Article  Google Scholar 

Download references

Acknowledgments

This project is supported by the European Union in the 5th Framework Programme: Quality of Life and Management of Living Resources—Key action 6: The Ageing Population and Disabilities. 6.5: Health and Social Care Services to Older People (Contract: QLK6-CT-2002-02647) and a grant from the Östergötland county council, Sweden.

Author information

Authors and Affiliations

  1. Center for Medical Technology Assessment (CMT), Department of Medicine and Health Sciences, Linköping University, 581 83, Linköping, Sweden

    Thomas Davidson & Lars-Åke Levin

  2. Division of Physiotherapy, Department of Medicine and Health Sciences, Linköping University, Linköping, Sweden

    Barbro Krevers

Authors
  1. Thomas Davidson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Barbro Krevers
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lars-Åke Levin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thomas Davidson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Davidson, T., Krevers, B. & Levin, LÅ. In pursuit of QALY weights for relatives: empirical estimates in relatives caring for older people. Eur J Health Econ 9, 285–292 (2008). https://doi.org/10.1007/s10198-007-0076-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10198-007-0076-z

Keywords

Search

Navigation