Economic Burden of Informal Caregiving Associated With History of Stroke and Falls Among Older Adults in the US
Economic Burden of Informal Caregiving Associated With History of Stroke and Falls Among Older Adults in the US
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DOI：
10.1016/j.amepre.2017.07.020
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发表时间：
2017-12-01
影响因子：
5.5
通讯作者：
Sleet, David
中科院分区：
文献类型：
--
作者：
Joo, Heesoo;Wang, Guijing;Sleet, David
导语：老年人中风和跌倒的风险很高，这两种疾病都需要大量的非正式护理。然而，与中风和跌倒病史相关的非正式护理的经济负担还不是很清楚。方法：使用2010年的健康和退休研究，分析2015-2017年间65岁(N=10,129)的非制度化成年人的数据。两部分模型被用来估计非正式照看时间。基于重置成本方法对模型的估计，作者得出了过去两年中风和非中风患者与跌倒相关的非正式护理时间和费用。结果：中风患者的整体跌倒和跌伤合并摔倒的患病率均高于非中风患者(跌倒的发生率为49.5%比35.1%，损伤性跌倒的发生率为16.0%比10.3%，p<；0.01)。中风幸存者比非中风幸存者需要更多的非正式护理时间，非正式护理时间的数量与非损伤性跌倒呈正相关，与损伤性跌倒的相关性更大。对于卒中幸存者(约50万人)和从未发生过中风的人(约360万人)来说，与损伤性跌倒相关的非正式护理(2015年美元)的国家负担总计29亿美元(95%CI=11亿美元，47亿美元)，而对于从未发生过中风的人(约360万人)，非正式护理的负担为65亿美元(95%CI=43亿美元，87亿美元)。结论：在美国老年人中，与跌倒相关的非正式护理时间和成本很大，尤其是对中风幸存者。因此，预防跌倒和跌倒相关伤害，特别是中风幸存者的跌倒和跌倒相关伤害，有可能减轻非正式护理的负担。(C)《2017美国预防医学杂志》。由爱思唯尔公司出版。
Introduction: Older adults are at high risk for stroke and falls, both of which require a large amount of informal caregiving. However, the economic burden of informal caregiving associated with stroke and fall history is not well known.Methods: Using the 2010 Health and Retirement Study, data on non-institutionalized adults aged >= 65 years (N=10,129) in 2015-2017 were analyzed. Two-part models were used to estimate informal caregiving hours. Based on estimates from the models using a replacement cost approach, the authors derived informal caregiving hours and costs associated with falls in the past 2 years for stroke and non-stroke persons.Results: Both the prevalence of falls overall and of falls with injuries were higher among people with stroke than those without (49.5% vs 35.1% for falls and 16.0% vs 10.3% for injurious falls, p < 0.01). Stroke survivors needed more informal caregiving hours than their non-stroke counterparts, and the number of informal caregiving hours was positively associated with non-injurious falls and even more so with injurious falls. The national burden of informal caregiving (2015 U.S. dollars) associated with injurious falls amounted to $2.9 billion (95% CI=$1.1 billion, $4.7 billion) for stroke survivors (about 0.5 million people), and $6.5 billion (95% CI=$4.3 billion, $8.7 billion) for those who never had a stroke (about 3.6 million people).Conclusions: In U.S. older adults, informal caregiving hours and costs associated with falls are substantial, especially for stroke survivors. Preventing falls and fall-related injuries, especially among stroke survivors, therefore has potential for reducing the burden of informal caregiving. (C) 2017 American Journal of Preventive Medicine. Published by Elsevier Inc.