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Public financial support receipt and non-medical resource utilization in Alzheimer's disease results from the PLASA study

Listed author(s):
  • Rapp, Thomas
  • Grand, Alain
  • Cantet, Christelle
  • Andrieu, Sandrine
  • Coley, Nicola
  • Portet, Florence
  • Vellas, Bruno

A major health policy objective is to encourage and sustain informal caregiving networks for people with Alzheimer's disease (AD). This goal can be reached by providing financial assistance to patients facing difficulties in the accomplishment of activities of daily living, in order to encourage utilization of professional service and therefore alleviate informal caregiver burden. The main issue is to understand if and how financial assistance is correlated with the distribution between informal and professional care. We used a cross-sectional sample of 1131 French elderly patients (>=65) with mild to moderate AD. Informal and professional service resource use was measured in hours per month using a validated instrument, the Resource Use in Dementia questionnaire. Our results confirmed the utter dominance of informal care, which represented more than 80% of total care even among patients receiving public financial support. However financial support receipt was associated with differences in care utilization: higher use of total non-medical care (formal and informal) and lower proportion of informal care in total non-medical care. Our results suggested the presence of a threshold effect that would influence non-medical care demand decisions. Even if on average the use of informal care in total was 13.3% lower among patients receiving public financial support, informal care use represented more than 80% of total non-medical care use. Providing robust evidence of these associations is crucial to further identify the right dosage between professional service demand and informal care utilization that could be associated with a lower burden and therefore a lower probability of institutionalization.

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File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(11)00143-2
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Article provided by Elsevier in its journal Social Science & Medicine.

Volume (Year): 72 (2011)
Issue (Month): 8 (April)
Pages: 1310-1316

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Handle: RePEc:eee:socmed:v:72:y:2011:i:8:p:1310-1316
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  1. Hanaoka, Chie & Norton, Edward C., 2008. "Informal and formal care for elderly persons: How adult children's characteristics affect the use of formal care in Japan," Social Science & Medicine, Elsevier, vol. 67(6), pages 1002-1008, September.
  2. Joseph E. Gaugler & Robert L. Kane & Robert Newcomer, 2007. "Resilience and Transitions From Dementia Caregiving," Journals of Gerontology: Series B, Gerontological Society of America, vol. 62(1), pages 38-44.
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  4. van den Berg, Bernard & Brouwer, Werner & van Exel, Job & Koopmanschap, Marc & van den Bos, Geertrudis A.M. & Rutten, Frans, 2006. "Economic valuation of informal care: Lessons from the application of the opportunity costs and proxy good methods," Social Science & Medicine, Elsevier, vol. 62(4), pages 835-845, February.
  5. O'Reilly, Dermot & Connolly, Sheelah & Rosato, Michael & Patterson, Chris, 2008. "Is caring associated with an increased risk of mortality? A longitudinal study," Social Science & Medicine, Elsevier, vol. 67(8), pages 1282-1290, October.
  6. K. Bolin & B. Lindgren & P. Lundborg, 2008. "Informal and formal care among single-living elderly in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 393-409.
  7. Stabile, Mark & Laporte, Audrey & Coyte, Peter C., 2006. "Household responses to public home care programs," Journal of Health Economics, Elsevier, vol. 25(4), pages 674-701, July.
  8. Morgan, Debra G. & Semchuk, Karen M. & Stewart, Norma J. & D'Arcy, Carl, 2002. "Rural families caring for a relative with dementia: barriers to use of formal services," Social Science & Medicine, Elsevier, vol. 55(7), pages 1129-1142, October.
  9. Van Houtven, Courtney Harold & Norton, Edward C., 2008. "Informal care and Medicare expenditures: Testing for heterogeneous treatment effects," Journal of Health Economics, Elsevier, vol. 27(1), pages 134-156, January.
  10. Heitmueller, Axel & Inglis, Kirsty, 2007. "The earnings of informal carers: Wage differentials and opportunity costs," Journal of Health Economics, Elsevier, vol. 26(4), pages 821-841, July.
  11. van den Berg, Bernard & Al, Maiwenn & Brouwer, Werner & van Exel, Job & Koopmanschap, Marc, 2005. "Economic valuation of informal care: The conjoint measurement method applied to informal caregiving," Social Science & Medicine, Elsevier, vol. 61(6), pages 1342-1355, September.
  12. Cannuscio, Carolyn C. & Colditz, Graham A. & Rimm, Eric B. & Berkman, Lisa F. & Jones, Camara P. & Kawachi, Ichiro, 2004. "Employment status, social ties, and caregivers' mental health," Social Science & Medicine, Elsevier, vol. 58(7), pages 1247-1256, April.
  13. Wimo, Anders & von Strauss, Eva & Nordberg, Gunilla & Sassi, Franco & Johansson, Lennarth, 2002. "Time spent on informal and formal care giving for persons with dementia in Sweden," Health Policy, Elsevier, vol. 61(3), pages 255-268, September.
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