Estimating the cost of informal caregiving for elderly patients with cancer

Purpose: As the United States population ages, the increasing prevalence of cancer is likely to result in higher direct medical and nonmedical costs. Although estimates of the associated direct medical costs exist, very littl e information is available regarding the prevalence, time, and cost associa ted with informal caregiving for elderly cancer patients. Materials and Methods: To estimate these costs, we used delta from the firs t wave (1993) of the Asset and Health Dynamics (AHEAD) Study, a nationally representative longitudinal survey of people aged 70 or older. Using a mult ivariable, two-part regression model to control for differences in health a nd functional status, social support, and sociodemographics, we estimated t he probability of receiving informal care, the average weekly number of car egiving hours, and the average annual caregiving cost per case (assuming an average hourly wage of $8.17) for subjects who reported no history of canc er (NC), having a diagnosis of cancer but not receiving treatment for their cancer in the last year (CNT), and having a diagnosis of cancer and receiv ing treatment in the last year (CT). Results: Of the 7,443 subjects surveyed, 6,422 (86%) reported NC, 718 (10%) reported CNT, and 303 (4%) reported CT. Whereas the adjusted probability o f informal caregiving for those respondents reporting NC and CNT was 26%, i t was 34% for those reporting CT (P < .05), Those subjects reporting CT rec eived an average of 10.0 hours of informal caregiving per week, as compared with 6.9 and 6.8 hours for those who reported NC and CNT, respectively (P < .05). Accordingly, cancer treatment was associated with an incremental in crease of 3.1 hours per week, which translates into an additional average y early cost of $1,200 per patient and just over $1 billion nationally. Conclusion: Informal caregiving costs are substantial and should be conside red when estimating the cost of cancer treatment in the elderly. (C) 2001 b y American Society of Clinical Oncology.