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BMC Health Services Research

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Open Access 01-12-2023 | Care | Research

Labor market costs for long-term family caregivers: the situation of caregivers of persons with spinal cord injury in Switzerland

Authors: Monica Ruoss, Mirjam Brach, Diana Pacheco Barzallo

Published in: BMC Health Services Research | Issue 1/2023

Abstract

Background

Family members are key in the provision of care to persons facing disability. To undertake the role as caregivers, they face many costs, being the setback in the labor market one of the most relevant.

Methods

We analyze comprehensive data from long-term family caregivers of persons with spinal cord injury (SCI) in Switzerland. Using information about their working situation before and after becoming caregivers, we estimated the reduction in working hours and the associated income loss.

Results

On average, family caregivers reduced their working hours by about 23% (8.4 h per week), which has a monetary value of CHF 970 per month (EUR 845). Women, older caregivers, and less educated caregivers have a much higher opportunity cost in the labor market: CHF 995 (EUR 867), CHF 1,070 (EUR 932), and CHF 1,137 (EUR 990) respectively. In contrast, family members who care for a person that works have a much lower impact on their working status, CHF 651 (EUR 567). Interestingly, the reduction in their working time is only a third of the extra work they face as caregivers.

Conclusion

Health and social systems rely on the unpaid work of family caregivers. To guarantee their long-term involvement, family caregivers need to be recognized for their work and potentially compensated. Without family caregivers, it is very unlikely societies can cope with the increasing need for care, as professional services are limited and expensive.

van den Berg B, Brouwer WBF, Koopmanschap MA. Economic valuation of informal care. An overview of methods and applications. Eur J Health Econ. 2004;5(1):36–45.CrossRefPubMed

Arksey H. Combining informal care and work: supporting carers in the workplace. Health Soc Care Community. 2002;10(3):151–61. https://doi.org/10.1046/j.1365-2524.2002.00353.x.

Bauer J, Sousa-Poza A. Impacts of Informal Caregiving on Caregiver Employment, Health, and Family. Popul Ageing. 2015;8:113–145. https://doi.org/10.1007/s12062-015-9116-0.

Goodrich K, Kaambwa B, Al-Janabi H. The inclusion of informal care in applied economic evaluation: a review. Value Health. 2012;15(6):975–81.CrossRefPubMed

Lilly MB, Laporte A, Coyte PC. Labor market work and home care's unpaid caregivers: a systematic review of labor force participation rates, predictors of labor market withdrawal, and hours of work. Milbank Q. 2007;85(4):641-90. https://doi.org/10.1111/j.1468-0009.2007.00504.x.

Colombo F, et al. Help Wanted?: Providing and Paying for Long-Term Care, OECD Health Policy Studies, OECD Publishing, Paris; 2011. https://doi.org/10.1787/9789264097759-en.

Hoffmann F, Rodrigues R. Informal Carers: Who Takes Care of Them? Policy Brief 4/2010. Vienna: European Centre; 2010.

Gemperli A, Rubinelli S, Zanini C, Huang J, Brach M, Pacheco Barzallo D. Living situation of family caregivers of persons with spinal cord injury. J Rehabil Med. 2020;52(11):jrm00124. https://doi.org/10.2340/16501977-2762.

Charlifue SB, Botticello A, Kolakowsky-Hayner SA, Richards JS, Tulsky DS. Family caregivers of individuals with spinal cord injury: exploring the stresses and benefits. Spinal Cord. 2016;54(9):732–6.CrossRefPubMed

10.

Singh A, Tetreault L, Kalsi-Ryan S, Nouri A, Fehlings MG. Global prevalence and incidence of traumatic spinal cord injury. Clin Epidemiol. 2014;23(6):309–31.

11.

Kang Y, Ding H, Zhou HX, Wei ZJ, Liu L, Pan DY, Feng SQ. Epidemiology of worldwide spinal cord injury: a literature review. J Neurorestoratology. 2018;6:1–9. https://doi.org/10.2147/JN.S143236.

12.

Yoon J, Chee CP, Su P, Almenoff P, Zulman DM, Wagner TH. Persistence of High Health Care Costs among VA Patients. Health Serv Res. 2018;53(5):3898–916. https://doi.org/10.1111/1475-6773.12989.

13.

Huang J, Pacheco Barzallo D, Rubinelli S, et al. What influences the use of professional home care for individuals with spinal cord injury? A cross-sectional study on family caregivers. Spinal Cord. 2019;57:924–32. https://doi.org/10.1038/s41393-019-0296-y.

14.

Tikkanen R, Osborn R, Mossialos E, Djordjevic A, Wharton GA. International health care system profiles. The Commonwealth Fund [Internet]. 2020.

15.

Donelan K, Hill CA, Hoffman C, Scoles K, Feldman PH, Levine C, Gould D. Challenged to care: informal caregivers in a changing health system. Health Aff (Millwood). 2002;21(4):222–31. https://doi.org/10.1377/hlthaff.21.4.222.

16.

Gibson MJ, Houser A. Valuing the invaluable: a new look at the economic value of family caregiving. Issue Brief (Public Policy Inst (Am Assoc Retired Pers)). 2007;(IB82):1–12.

17.

Ansah JP, Matchar DB, Malhotra R, Love SR, Liu C, Do Y. Projecting the effects of long-term care policy on the labor market participation of primary informal family caregivers of elderly with disability: insights from a dynamic simulation model. BMC Geriatr. 2016;16:69. https://doi.org/10.1186/s12877-016-0243-0.

18.

The Lancet Healthy Longevity. Care for ageing populations globally. Lancet Healthy Longev. 2021;2(4):e180. https://doi.org/10.1016/S2666-7568(21)00064-7.

19.

Oliva-Moreno J, Trapero-Bertran M, Peña-Longobardo LM, Del Pozo-Rubio R. The Valuation of Informal Care in Cost-of-Illness Studies: A Systematic Review. Pharmacoeconomics. 2017;35(3):331–45.

20.

Grosse SD, Pike J, Soelaeman R, Tilford JM. Quantifying Family Spillover Effects in Economic Evaluations: Measurement and Valuation of Informal Care Time. Pharmacoeconomics. 2019;37(4):461–73.CrossRefPubMedPubMedCentral

21.

Paraponaris A, Davin B. Economics of the Iceberg: Informal Care Provided to French Elderly with Dementia. Value Health. 2015;18(4):368–75.CrossRefPubMed

22.

van den Berg B, Brouwer W, van Exel J, Koopmanschap M, van den Bos GAM, Rutten F. Economic valuation of informal care: lessons from the application of the opportunity costs and proxy good methods. Soc Sci Med. 2006;62(4):835–45.CrossRefPubMed

23.

van Exel J, Bobinac A, Koopmanschap M, Brouwer W. The invisible hands made visible: recognizing the value of informal care in healthcare decision-making. Expert Rev Pharmacoecon Outcomes Res. 2008;8(6):557–61. https://doi.org/10.1586/14737167.8.6.557.

24.

Committee on Family Caregiving for Older Adults; Board on Health Care Services; Health and Medicine Division; National Academies of Sciences, Engineering, and Medicine. Families Caring for an Aging America. Schulz R, Eden J, editors. Washington (DC): National Academies Press (US); 2016.

25.

Pletscher M, Mattli R, Reich O, Von Wyl A, Wieser S. The Societal Costs of Schizophrenia in Switzerland. Value Health J Int Soc Pharmacoeconomics Outcomes Res. 2014;17(7):A457.

26.

Kraft E, Marti M, Werner S, Sommer H. Cost of dementia in Switzerland. Swiss Med Wkly. 2010;140:w13093.PubMed

27.

Pacheco Barzallo D, Hernandez R, Brach M, Gemperli A. The economic value of long-term family caregiving. The situation of caregivers of persons with spinal cord injury in Switzerland. Health & Social Care in the Community [Internet]. [cited 2022 May 26];n/a(n/a). Available from: https://onlinelibrary.wiley.com/doi/abs/https://doi.org/10.1111/hsc.13668.

28.

Mudrazija S. Work-Related Opportunity Costs of Providing Unpaid Family Care In 2013 And 2050. Health Aff. 2019;38(6):1003–10.CrossRef

29.

Wilcox, V., Sahni, H. The Effects on Labor Supply of Living with Older Family Members Needing Assistance with Activities of Daily Living. J Fam Econ Iss. 2022. https://doi.org/10.1007/s10834-022-09880-x.

30.

Chari AV, Engberg J, Ray KN, Mehrotra A. The Opportunity Costs of Informal Elder-Care in the United States: New Estimates from the American Time Use Survey. Health Serv Res. 2015;50(3):871–82.CrossRefPubMed

31.

Ruiz-Adame Reina M, Correa M, Burton K. The opportunity costs of caring for people with dementia in Southern Spain. Gac Sanit. 2019;33(1):17–23.CrossRefPubMed

32.

Post MW, Brinkhof MW, von Elm E, Boldt C, Brach M, Fekete C, Eriks-Hoogland I, Curt A, Stucki G; SwiSCI study group. Design of the Swiss Spinal Cord Injury Cohort Study. Am J Phys Med Rehabil. 2011;90(11 Suppl 2):S5–16. https://doi.org/10.1097/PHM.0b013e318230fd41.

33.

Statistik B für. Salarium – Statistischer Lohnrechner [Internet]. [cited 2022 May 26]. Available from: https://www.bfs.admin.ch/bfs/de/home/statistiken/arbeit-erwerb/loehne-erwerbseinkommen-arbeitskosten/lohnniveau-schweiz/salarium.html.

34.

Office fédéral de la statistique, Enquête sur le budget des ménages (EBM) Renseignements: Enquête sur le budget des ménages, ebm@bfs.admin.ch, tél. 058 467 25 83© OFS – Encyclopédie statistique de la Suisse.

35.

Federal Statistical Office. Labour market indicators for 2021 [Internet]. Neuchatel, Switzerland; 2021 Aug. (Work and Income). Report No.: FSO News. Available from: https://www.swissstats.bfs.admin.ch/collection/ch.admin.bfs.swissstat.en.issue21032062106/article/issue21032062106-01.

36.

OECD. Part-time employment rate (indicator). 2023. https://doi.org/10.1787/f2ad596c-en.

37.

Riewpaiboon A, Riewpaiboon W, Ponsoongnern K, Van den Berg B. Economic valuation of informal care in Asia: a case study of care for disabled stroke survivors in Thailand. Soc Sci Med. 2009;69(4):648–53.CrossRefPubMed

38.

Muurinen JM. The economics of informal care. Labor market effects in the National Hospice Study. Med Care. 1986;24(11):1007–17.CrossRefPubMed

39.

Estrada Fernández ME, Gil Lacruz AI, Gil Lacruz M, Viñas López A. Informal care. European situation and approximation of a reality. Health Policy. 2019;123(12):1163–72. https://doi.org/10.1016/j.healthpol.2019.09.007.

40.

van Broese Groenou MI, De Boer A. Providing informal care in a changing society. Eur J Ageing. 2016;13(3):271–9.CrossRef

41.

Pacheco Barzallo D. Spillover Effects of Long-Term Disabilities on Close Family Members. Appl Health Econ Health Policy. 2018;16(3):347–55. https://doi.org/10.1007/s40258-018-0391-9.

42.

Blanes L, Carmagnani MIS, Ferreira LM. Health-related quality of life of primary caregivers of persons with paraplegia. Spinal Cord. 2007;45(6):399–403.CrossRefPubMed

Title: Labor market costs for long-term family caregivers: the situation of caregivers of persons with spinal cord injury in Switzerland
Authors: Monica Ruoss
Mirjam Brach
Diana Pacheco Barzallo
Publication date: 01-12-2023
Publisher: BioMed Central
Keyword: Care
Published in: BMC Health Services Research / Issue 1/2023
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-023-09565-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Labor market costs for long-term family caregivers: the situation of caregivers of persons with spinal cord injury in Switzerland

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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