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http://repositorio.inger.gob.mx/jspui/handle/20.500.12100/17108| Title: | Economic burden to primary informal caregivers of hospitalized older adults in Mexico: a cohort study |
| metadata.dc.creator: | MARIANA LOPEZ ORTEGA MARIA DEL CARMEN GARCIA PEÑA VICTOR GRANADOS GARCIA JOSE JUAN GARCIA GONZALEZ MARIO ULISES PEREZ ZEPEDA |
| Keywords: | MEDICINA Y CIENCIAS DE LA SALUD;Ciencias médicas;Ciencias clínicas;Geriatría;Personas mayores;Cuidadores (economía);Cuidado geriátrico agudo;Geriatrics;Elderly;Caregivers (economics);Acute geriatric care |
| metadata.dc.date: | 8-Feb-2013 |
| Publisher: | BioMed Central |
| Description: | Abstract: Background
The burden of out of pocket spending for the Mexican population is high compared to other countries. Even patients insured by social security institutions have to face the cost of health goods, services or nonmedical expenses related to their illness. Primary caregivers, in addition, experience losses in productivity by taking up responsibilities in care giving activities. This situation represents a mayor economic burden in an acute care setting for elderly population. There is evidence that specialized geriatric services could represent lower overall costs in these circumstances and could help reduce these burdens.
The aim of this study was to investigate economic burden differences in caregivers of elderly patients comparing two acute care services (Geriatric and Internal Medicine). Specifically, economic costs associated with hospitalization of older adults in these two settings by evaluating health care related out of pocket expenditures (OOPE), non-medical OOPE and indirect costs.
Methods
A comparative analysis of direct and indirect costs in hospitalised elderly patients (60-year or older) and their primary informal caregivers in two health care settings, using a prospective cohort was performed. Economic burden was measured by out of pocket expenses and indirect costs (productivity lost) due to care giving activities. The analysis included a two-part model, the first one allowing the estimation of the probability of observing any health care related and non-medical OOPE; and the second one, the positive observations or expenditures.
Results
A total of 210 subjects were followed during their hospital stay. Of the total number of subjects 95% reported at least one non-medical OOPE, being daily transportation the most common expense. Regarding medical OOPE, medicines were the most common expense, and the mean numbers of days without income were 4.12 days. Both OOPE and indirect costs were significantly different between type of services, with less overall economic burden to the caregivers of elderly hospitalized in the geriatric unit. The final model showed that type of service and satisfaction had the largest coefficients (-0.68 and 0.662 respectively, p<0.001).
Conclusions
This study allowed us to identify associated factors of economic burden in elderly hospitalized in acute care units. It opens as well, an issue that should not be overlooked in framing public policies regarding elderly health care. Conclusions: This study allowed us to identify economic burden related to acute care of elderly; in particular expenses often overlooked, potentially impacting the family, and should alert stakeholders from different sectors to open an agenda on this issue in order to reframe on going public policies or start new ones that give response to these unmet needs of a growing sector of the population. It also gives light to the urgent need to have more studies on informal care for older adults in order to properly inform such policies. Although the data is restricted to a social security institution, the IMSS, it provides services for approximately 35% of total population in the country and we could say this study can represent a relevant portion of total population. In addition, this study adds to the scarce literature in Latin America on OOPE and diverse factors of informal care giving for older adults. This can be used to inform older adult care policies and generate further information as to design schemes that support informal carers and allows older adults to have the best care possible, reduce hospitalisations, etc. |
| URI: | http://repositorio.inger.gob.mx/jspui/handle/20.500.12100/17108 |
| Appears in Collections: | 1. Artículos |
Files in This Item:
| File | Description | Size | Format | |
|---|---|---|---|---|
| 1172-6963-13-51.pdf | 317.48 kB | Adobe PDF | View/Open |