Disutility of illness for caregivers and families: a systematic review of the literature.
Disutility of illness for caregivers and families: a systematic review of the literature.
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DOI：
10.1007/s40273-013-0040-y
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发表时间：
2013-06
影响因子：
4.4
通讯作者：
Prosser, Lisa A.
中科院分区：
文献类型：
--
作者：
Wittenberg, Eve;Prosser, Lisa A.
照顾生病或残疾的家庭成员给照顾者带来了有据可查的负担。如果没有考虑到对家庭成员的“外溢”影响，就可能低估保健干预措施的效益，从而导致经济评价的结论不准确。通过对文献的系统回顾，提供疾病对家庭成员、亲属和照顾者的溢出负效用的估计，并总结测量方法。从2012年2月开始，我们检索了医学（PubMED）、心理学（PsycINFO）和经济学（EconLit）的文献，以研究疾病对家庭成员和照顾者的溢出负效用。纳入标准为：(1)使用基于偏好的健康相关生活质量测量方法的研究，(2)报告溢出负效用的研究，或(3)报告可以推断溢出负效用的数据的研究。本综述纳入了15项研究：7项报告了溢出负效用的估计，8项报告了可以推断负效用的数据。三项研究没有发现与溢出相关的负效用，而12项研究发现可测量的影响高达- 0.718（两项研究在其样本子集中发现了积极溢出的证据）。通用（间接）效用工具主要用于测量溢出，包括EQ-5D、QWB和HUI (n=13)，尽管有两项研究使用了修改版本的时间权衡技术。研究的疾病包括儿童疾病（如脊柱裂、先天性畸形）、老年人疾病（如阿尔茨海默病和痴呆症）、身体致残状况（如关节炎、多发性硬化症）以及癌症和中风等医疗状况。受外溢影响的人包括父母、祖父母、配偶/伴侣、其他家庭照顾者和家庭成员。关于疾病对家庭成员和照顾者的溢出负效用的文献有限，对特定条件和个人的一般较小的负面影响提供了一些具体的估计。测量方法因研究而异，尚未达成共识。有证据表明，在经济评估中纳入溢出效应将提高处理有溢出效应条件的干预措施的相对有效性，尽管这种差异效益可能仅限于此类特定情况。
Caring for an ill or disabled family member imposes a well-documented burden on the caregiver. The benefits of a health intervention may be underestimated if “spillover” effects on family members are not captured, resulting in inaccurate conclusions of economic evaluations. To provide an estimate of, and to summarize measurement approaches for, the spillover disutility of illness on family members, relatives, and caregivers, through a systematic review of the literature. The medical (PubMED), psychology (PsycINFO) and economics (EconLit) literatures were searched from inception through February, 2012 for published studies measuring spillover disutility of illness on family members and caregivers. Inclusion criteria were (1) studies using preference-based measures of health-related quality of life, and (2) studies reporting spillover disutility, or (3) studies reporting data from which a spillover disutility could be inferred. Fifteen studies were included in this review: 7 reported estimates of spillover disutility and 8 reporting data from which disutility could be inferred. Three studies found no disutility associated with spillover while 12 found measurable effects as large as −0.718 (and two found evidence of positive spillover in subsets of their samples). Generic (indirect) utility instruments were primarily used to measure spillover, including the EQ-5D, QWB and HUI (n=13), though two studies used modified versions of the time trade-off technique. Illnesses studied included childhood disorders (e.g., spina bifida, congenital malformations), diseases of the elderly (e.g., Alzheimer’s disease and dementia), physically disabling conditions (e.g., arthritis, multiple sclerosis), and medical conditions such as cancer and stroke. The persons affected by spillover included parents, grandparents, spouses/partners, other family caregivers, and household members. There is a limited literature on the spillover disutility of illness on family members and caregivers, providing some specific estimates of a generally small, negative effect for particular conditions and individuals. Measurement methods vary across studies and a consensus approach has not yet been reached. Evidence suggests that the inclusion of spillover effects in economic evaluations would increase the relative effectiveness of interventions that address conditions with spillover compared to those without, though such differential benefits may be limited to such specific circumstances.
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影响因子：
4.1
作者：
Gusi, Narcis;Prieto, Josue;Gonzalez-Guerrero, Jose L.
通讯作者：
Gonzalez-Guerrero, Jose L.
影响因子：
158.5
作者：
Christakis, Nicholas A.;Fowler, James H.
通讯作者：
Fowler, James H.
影响因子：
158.5
作者：
Christakis, Nicholas A.;Fowler, James H.
通讯作者：
Fowler, James H.
影响因子：
3.6
作者：
Al-Janabi, Hareth;Flynn, Terry N.;Coast, Joanna
通讯作者：
Coast, Joanna
影响因子：
5.4
作者：
Al-Janabi, Hareth;Coast, Joanna;Flynn, Terry N.
通讯作者：
Flynn, Terry N.