Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-12-01T02:54:14.280Z Has data issue: false hasContentIssue false

Economic Evaluation of A Support Program for Caregivers of Demented Elderly

Published online by Cambridge University Press:  10 March 2009

Michael F. Drummond
Affiliation:
University of York
E. Ann Mohide
Affiliation:
McMaster University
Michelle Tew
Affiliation:
McMaster University
David L. Streiner
Affiliation:
McMaster University
Dorothy M. Pringle
Affiliation:
University of Toronto
J. Raymond Gilbert
Affiliation:
McMaster University

Abstract

An economic evaluation was undertaken concurrently with a randomized trial comparing a Caregiver Support Program (CSP) with existing conventional community nursing care for those caring for elderly relatives at home. The differences in resource consumption were compared with changes in caregiver quality of life, as measured by the Caregiver Quality of Life Instrument (CQLI). A 20% difference from baseline in the CQLI favored the experimental (CSP) group, although this did not reach conventional levels of statistical significance. A comparison of improvement in quality of life with costs implies an incremental cost per quality-adjusted life year gained of Canadian $20,000 for the CSP, which compares favorably with other health care interventions. Further, larger studies are required to confirm this result.

Type
General Essays
Copyright
Copyright © Cambridge University Press 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Anthony-Bergstone, C. R., Zarit, S. H., & Gatz, M.Symptoms of psychological distress among caregivers of dementia patients. Psychology and Aging, 1988, 3, 245–48.CrossRefGoogle ScholarPubMed
2.Blessed, G., Tomlinson, B. E., & Roth, M.The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. British Journal of Psychiatry, 1968, 114, 797811.CrossRefGoogle ScholarPubMed
3.Caserta, M. S., Lund, D. A., Wright, S. D., et al. Caregivers to dementia patients: The utilization of community services. The Gerontologist, 1987, 27, 209–14.CrossRefGoogle Scholar
4.Cohen, J.Statistical power analysis for the behavioral sciences. New York: Academic, 1969.Google Scholar
5.Drummond, M. F., & Stoddart, G. L.Economic analysis and clinical trials. Controlled Clinical Trials, 1984, 5, 115–28.CrossRefGoogle ScholarPubMed
6.Drummond, M. F., Stoddart, G. L., & Torrance, G. W.Methods for the economic evaluation of health care programmes. Oxford and New York: Oxford University Press, 1987.Google Scholar
7.Eagles, J. M., Beattie, J. A. G., Blackwood, G. W., et al. The mental health of elderly couples. I. The effects of a cognitively impaired spouse. British Journal of Psychiatry, 1987, 150, 299303.CrossRefGoogle ScholarPubMed
8.Fitting, M., Rabins, P., Lucas, M. J., et al. Caregivers for dementia patients: A comparison of husbands and wives. The Gerontologist, 1986, 26, 248–52.CrossRefGoogle ScholarPubMed
9.Folstein, M. F., Folstein, S. E., & McHugh, P. R.Mini-Mental State: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 1975, 12, 189–98.CrossRefGoogle Scholar
10.Greene, J. G., Smith, R., Gardiner, M., et al. Measuring behavioral disturbance of elderly demented patients in the community and its effect on relatives: A factor analytic study. Age and Aging, 1982, 11, 121–26.CrossRefGoogle ScholarPubMed
11.Haley, W. E., Levine, E. G., Brown, S. L., et al. Psychological, social, and health consequences of caring for a relative with senile dementia. Journal of the American Geriatrics Society, 1987, 35, 405–11.CrossRefGoogle ScholarPubMed
12.Kyle, D. R., Drummond, M. F., & White, D. M. D.The Hereford District Department of Mental Health of the Elderly: A preliminary evaluation. Community Medicine, 1987, 9, 3546.Google ScholarPubMed
13.Mohide, E. A., Pringle, D. M., Streiner, D. L., Gilbert, J. R., et al. A randomized trial of family caregiver support in the home management of dementia. Journal of the American Geriatrics Society, 1990, 38, 446–54.CrossRefGoogle ScholarPubMed
14.Mohide, E. A., Torrance, G. W., Streiner, D. L., et al. Measuring the wellbeing of family caregivers using the time trade-off technique. Journal of Clinical Epidemiology, 1988, 41, 475–82.CrossRefGoogle ScholarPubMed
15.Mooney, G. H., Russell, E. M., & Weir, R. D. Marginal analysis: A case study in care of the elderly. In Choices in Health Care, London: Macmillan, 1980, 77.CrossRefGoogle Scholar
16.Rabins, P., Mace, N., & Lucas, M.The impact of dementia on the family. Journal of the American Medical Association, 1982, 248, 333–35.CrossRefGoogle ScholarPubMed
17.Radloff, L. S.The CES-D Scale: A new self-report depression scale for research in the general population. Applied Psychological Measurement, 1977, 1, 385401.CrossRefGoogle Scholar
18.Reisberg, B., Ferris, S., DeLeon, M., et al. The Global Deterioration Scale for assessment of primary degenerative dementia. American Journal of Psychiatry, 1982, 139, 1136–39.Google ScholarPubMed
19.Robertson, D., Rockwood, K., & Stolee, P.A short mental status questionnaire. Canadian Journal on Aging, 1982, 1, 1620.CrossRefGoogle Scholar
20.Robinson, B. C.Validation of a caregiver strain index. Journal of Gerontology, 1983, 38, 344–48.CrossRefGoogle ScholarPubMed
21.Siegel, S., & Castellan, N. J.Nonparametric statistics for the behavioral sciences, 2nd ed.New York: McGraw-Hill Book Company, 1988.Google Scholar
22.Spielberger, G., Gorsuch, R., & Lushene, R.STAI manual for the State-Trait Anxiety Inventory. California: Consulting Psychologists Press, 1968.Google Scholar
23.Torrance, G. W., Thomas, W. H., & Sackett, D. L.A utility maximization model for evaluation of health care programs. Health Service Research, 1972, 7, 118–33.Google ScholarPubMed
24.Torrance, G. W., & Zipursky, A.Cost-effectiveness of antepartum prevention of Rh immunization. Clinics in Perinatology, 1984, 11, 267–81.CrossRefGoogle ScholarPubMed
25.Warner, K. E., & Luce, B. R.Cost-benefit and cost-effectiveness analysis in health care. Ann Arbor, MI: Health Administration Press, 1982.Google ScholarPubMed
26.Weissert, W. G.Seven reasons why it is so difficult to make community-based long-term care cost-effective. Health Services Research, 1985, 20, 423–33.Google ScholarPubMed
27.Weissert, W. G., Wan, T. T. H., Livieratos, B. B., et al. Cost-effectiveness of homemaker services for the chronically ill. Inquiry, 1980, 17, 230–43.Google ScholarPubMed
29.Wright, K. G., Cairns, J. A., & Snell, M. C. Costing Care. Social Services Monographs, Sheffield, UK: University of Sheffield Joint Unit for Social Services Research, 1981.Google Scholar
28.Williams, A. H.Economics of coronary artery bypass grafting. British Medical Journal, 1985, 291, 326–29.CrossRefGoogle ScholarPubMed
30.Zarit, S., Reever, K. E., & Bach-Peterson, J.Relatives of the impaired elderly: Correlates of feelings of burden. The Gerontologist, 1980, 20, 649–55.CrossRefGoogle ScholarPubMed