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Elayan S, Angelini V, Buskens E, de Boer A. The Economic Costs of Informal Care: Estimates from a National Cross-Sectional Survey in The Netherlands. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024:10.1007/s10198-023-01666-8. [PMID: 38294595 DOI: 10.1007/s10198-023-01666-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 12/21/2023] [Indexed: 02/01/2024]
Abstract
Faced with an unprecedented demand for long-term care, European health care systems are moving towards mixed care models, where the welfare state and informal caregivers share care responsibilities. While informal care is often viewed as a means of alleviating pressure on public care, it comes with significant economic costs for caregivers, their employers, and society at large. This study uses nationally representative data to estimate the total direct (informal care time and out-of-pocket costs) and indirect (productivity) economic costs of informal care in the Netherlands in 2019. Informal care time costs are estimated using the opportunity cost and the proxy good methods. Indirect costs are estimated using the human capital and friction cost approaches. Our results reveal the considerable annual societal cost of informal care in the Netherlands, ranging between €17.5 billion and €30.1 billion, depending on the valuation approach. These costs are equivalent to 2.15% and 3.71% of Dutch GDP in 2019, comparable to the public expenditure on long-term care in that year. Female caregivers account for slightly more than half (53%-57%) of the total costs. Around 57%-88% of these costs are in the form of informal care time. The main driver of indirect costs is the temporary cessation of work, which comprises 12%-17% of the total costs. Findings corroborate that substantial resources, yet thus far largely disregarded, are spent on informal care even in a country with a relatively generous public long-term care system.
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Affiliation(s)
- Saif Elayan
- Department of Economics, Econometrics and Finance, Faculty of Economics and Business, University of Groningen, Nettelbosje 2, 9747 AE, Groningen, The Netherlands.
| | - Viola Angelini
- Department of Economics, Econometrics and Finance, Faculty of Economics and Business, University of Groningen, Nettelbosje 2, 9747 AE, Groningen, The Netherlands
| | - Erik Buskens
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Alice de Boer
- Faculty of Social Sciences, Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
- The Netherlands Institute for Social Research (SCP), 2500 BD, The Hague, The Netherlands
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Brouwer W, Verbooy K, Hoefman R, van Exel J. Production Losses due to Absenteeism and Presenteeism: The Influence of Compensation Mechanisms and Multiplier Effects. PHARMACOECONOMICS 2023; 41:1103-1115. [PMID: 36856941 PMCID: PMC9976676 DOI: 10.1007/s40273-023-01253-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Productivity costs can form a large and influential component of total costs in an economic evaluation taking a societal perspective. In calculating productivity costs, estimating productivity losses is a central element. Compensation mechanisms and multiplier effects may influence these losses but remain understudied. Compensation mechanisms could reduce productivity losses while multiplier effects may increase them. METHODS Data on productivity losses were collected in 2015 using an online survey among a sample of persons aged 15-65 years in The Netherlands who worked at least 12 h per week and reported to have experienced absenteeism and/or presenteeism during the past 4 weeks. A total of 877 respondents completed the survey that contained questions on productivity losses, compensation mechanisms, and multiplier effects. RESULTS We found that 45.5% of the respondents reported absenteeism (average 6.5 days) during the past 4 weeks, losing on average 48.7 working hours, while presenteeism was experienced by 75.9% of respondents, with an average loss of 10.7 working hours. Compensation mechanisms were reported by 76.9% of respondents, compensating almost 80% of their lost production, while multiplier effects were reported by 23.6% of respondents, reducing the productivity of 4.2 colleagues by 27.8% on average, implying a multiplier of 2.1 in that subgroup. CONCLUSIONS This study highlights that compensation mechanisms and multiplier effects are common and may substantially affect production losses. Investigating these mechanisms and effects further, as well as their interactions, remains important. Translating these findings into productivity cost calculations in economic evaluations is not straightforward and requires attention, especially since compensation mechanisms may not be costless and, for multiplier effects, the value of hours of colleagues may not be similar to that of the person experiencing health problems.
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Affiliation(s)
- Werner Brouwer
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, PO Box 1738, 3000 DR, Rotterdam, The Netherlands.
- Erasmus Centre for Health Economics Rotterdam, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Kaya Verbooy
- Hotel Management School Maastricht, Maastricht, The Netherlands
| | - Renske Hoefman
- The Netherlands Institute for Social Research, The Hague, The Netherlands
| | - Job van Exel
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, PO Box 1738, 3000 DR, Rotterdam, The Netherlands
- Erasmus Centre for Health Economics Rotterdam, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Engels C, Segaux L, Ibanez A, Canouï-Poitrine F, Lafont C. Which Occupations Did People Engage in during Lockdown? A European Cross-Sectional Descriptive Survey by Generation. Occup Ther Int 2023; 2023:3979298. [PMID: 37646069 PMCID: PMC10462442 DOI: 10.1155/2023/3979298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 04/24/2023] [Accepted: 07/28/2023] [Indexed: 09/01/2023] Open
Abstract
Objective The primary objective was to describe the occupations people engaged in more frequently during lockdown than before the coronavirus disease 2019 pandemic as a function of generation. The secondary objectives were to (i) describe the levels of importance, performance, and satisfaction for these occupations and (ii) identify factors affecting the levels of importance, performance, and satisfaction. Method We conducted an online, cross-sectional survey of young adults (YAs, aged 18-39), middle-aged adults (MAs, aged 40-59), and older adults (OAs, aged 60 or over). Results 2534 participants (YAs: 47%, MAs: 33%, and OAs: 20%) cited 4500 occupations. The occupations in which people most engaged were leisure occupations (67%), followed by productive occupations (31%) and then self-care (2%) occupations. YAs gave a median (interquartile range) importance score of 8 (6; 9) to leisure, 8 (7; 10) to productivity, and 8 (7; 10) to self-care. MAs gave a median importance score of 8 (6; 10) to leisure, 8 (7; 10) to productivity, and 8 (7; 10) to self-care. OAs gave a median importance score of 8 (7; 10) to leisure, 8 (7; 9) to productivity, and 9 (8; 10) to self-care. In a pre-/postlockdown comparison, the changes in performance scores among YAs were +5 (3; 6) for leisure, +4 (2; 5) for productivity, and +4 (3; 6) for self-care. Among MAs, these changes were, respectively, +4 (3; 6), +3 (2; 5), and +4.5 (3; 6). Among OAs, these changes were, respectively, +3 (1; 5) for leisure, +3 (2; 5) for productivity, and +2 (0; 4) for self-care. The changes in satisfaction scores among YAs were +3 (0; 5) for leisure, +3 (0; 5) for productivity, and +3 (1; 6) for self-care. Among MAs, these changes were, respectively, +3 (0; 5), +2 (0; 4), and +5 (0; 6). Among OAs, these changes were, respectively, +2 (0; 4), +2 (0; 4), and +2 (0; 4). Conclusions Lockdown led to stronger engagements in quiet leisure and alternative forms of socialization. Occupational therapists may have a role in helping community-dwelling people to balance and structure their new daily routine.
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Affiliation(s)
- Cynthia Engels
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, F-94010 Creteil, France
- Faculty of Health, Univ Paris Est Creteil, F-94010 Creteil, France
| | - Lauriane Segaux
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, F-94010 Creteil, France
- AP-HP, Henri Mondor Hospital, Public Health Service, F-94010 Creteil, France
| | - Amandine Ibanez
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, F-94010 Creteil, France
- Faculty of Health, Univ Paris Est Creteil, F-94010 Creteil, France
| | - Florence Canouï-Poitrine
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, F-94010 Creteil, France
- AP-HP, Henri Mondor Hospital, Public Health Service, F-94010 Creteil, France
| | - Charlotte Lafont
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, F-94010 Creteil, France
- AP-HP, Henri Mondor Hospital, Public Health Service, F-94010 Creteil, France
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Paltrinieri S, Bressi B, Mazzini E, Fugazzaro S, Rondini E, Giorgi Rossi P, Costi S. Activities Carried Out during the First COVID-19 Lockdown by Italian Citizens. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3906. [PMID: 36900917 PMCID: PMC10001561 DOI: 10.3390/ijerph20053906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/09/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
The SARS-CoV-2 pandemic has altered how citizens engage in activities. This study describes the new activities citizens engaged in during the first lockdown, factors that helped them cope with the confinement, the supports they used the most, and which supports they would have liked to receive. This cross-sectional study consists of an online survey made of 49 questions that was completed by the citizens of the province of Reggio Emilia (Italy) from 4 May until 15 June 2020. The outcomes of this study were explored by focusing on four of the survey questions. Of the 1826 citizens who responded, 84.2% had started new leisure activities. Males, participants who lived in the plain or foothills, and those who experienced nervousness engaged less in new activities, while those whose employment status changed, whose lifestyle worsened, or whose use of alcohol increased engaged in more activities. The support of family and friends, leisure activities, continuing to work, and an optimistic attitude were perceived to be of help. Grocery delivery and hotlines providing any type of information and mental health support were used frequently; a lack of health and social care services and of support in reconciling work with childcare was perceived. Findings may help institutions and policy makers to better support citizens in any future circumstances requiring prolonged confinement.
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Affiliation(s)
- Sara Paltrinieri
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
- Public Health Sciences PhD Program, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Barbara Bressi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
- PhD Program in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41124 Reggio Emilia, Italy
| | - Elisa Mazzini
- Scientific Directorate Hospital Network, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Ermanno Rondini
- Lega Italiana Contro i Tumori-LILT Reggio Emilia, 42123 Reggio Emilia, Italy
- Regional Center for Education in Health Promotion-Luoghi di Prevenzione, 42122 Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, Università di Modena e Reggio Emilia, 41124 Modena, Italy
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Seiler LK, Stolpe S, Stanislawski N, Stahl F, Witt M, Jonczyk R, Heiden S, Blume H, Kowall B, Blume C. Low impact of regular PCR testing on presence at work site during the COVID-19 pandemic: experiences during an open observational study in Lower Saxony 2020-21. BMC Public Health 2023; 23:240. [PMID: 36737718 PMCID: PMC9897879 DOI: 10.1186/s12889-023-15036-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 01/12/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Since social distancing during the COVID-19-pandemic had a profound impact on professional life, this study investigated the effect of PCR testing on on-site work. METHODS PCR screening, antibody testing, and questionnaires offered to 4,890 working adults in Lower Saxony were accompanied by data collection on demographics, family status, comorbidities, social situation, health-related behavior, and the number of work-related contacts. Relative risks (RR) with 95 % confidence intervals were estimated for the associations between regular PCR testing and other work and health-related variables, respectively, and working on-site. Analyses were stratified by the suitability of work tasks for mobile office. RESULTS Between April 2020 and February 2021, 1,643 employees underwent PCR testing. Whether mobile working was possible strongly influenced the work behavior. Persons whose work was suitable for mobile office (mobile workers) had a lower probability of working on-site than persons whose work was not suitable for mobile office (RR = 0.09 (95 % CI: 0.07 - 0.12)). In mobile workers, regular PCR-testing was slightly associated with working on-site (RR = 1.19 (0.66; 2.14)). In those whose working place was unsuitable for mobile office, the corresponding RR was 0.94 (0.80; 1.09). Compared to persons without chronic diseases, chronically ill persons worked less often on-site if their workplace was suitable for mobile office (RR = 0.73 (0.40; 1.33)), but even more often if their workplace was not suitable for mobile office (RR = 1.17 (1.04; 1.33)). CONCLUSION If work was suitable for mobile office, regular PCR-testing did not have a strong effect on presence at the work site. TRIAL REGISTRATION An ethics vote of the responsible medical association (Lower Saxony, Germany) retrospectively approved the evaluation of the collected subject data in a pseudonymized form in the context of medical studies (No. Bo/30/2020; Bo/31/2020; Bo/32/2020).
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Affiliation(s)
- Lisa K. Seiler
- grid.9122.80000 0001 2163 2777Institute of Technical Chemistry, Leibniz University Hannover, Hanover, Germany
| | - Susanne Stolpe
- grid.410718.b0000 0001 0262 7331Institute for Clinical Epidemiology, University Hospital Essen, Essen, Germany
| | - Nils Stanislawski
- grid.9122.80000 0001 2163 2777Institute of Microelectronic Systems, Leibniz University Hannover, Hanover, Germany
| | - Frank Stahl
- grid.9122.80000 0001 2163 2777Institute of Technical Chemistry, Leibniz University Hannover, Hanover, Germany
| | - Martin Witt
- grid.9122.80000 0001 2163 2777Institute of Technical Chemistry, Leibniz University Hannover, Hanover, Germany
| | - Rebecca Jonczyk
- grid.9122.80000 0001 2163 2777Institute of Technical Chemistry, Leibniz University Hannover, Hanover, Germany
| | - Stefanie Heiden
- grid.9122.80000 0001 2163 2777Institute of Innovation Research, Technology Management & Entrepreneurship, Leibniz University Hannover, Hanover, Germany
| | - Holger Blume
- grid.9122.80000 0001 2163 2777Institute of Technical Chemistry, Leibniz University Hannover, Hanover, Germany
| | - Bernd Kowall
- grid.410718.b0000 0001 0262 7331Institute for Clinical Epidemiology, University Hospital Essen, Essen, Germany
| | - Cornelia Blume
- Institute of Technical Chemistry, Leibniz University Hannover, Hanover, Germany.
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Zhang W, Sun H, Gelfand A, Sawatzky R, Pearce A, Anis AH, Prescott K, Lee C. Working From Home During the COVID-19 Pandemic: The Association With Work Productivity Loss Among Patients and Caregivers. J Occup Environ Med 2022; 64:e677-e684. [PMID: 35941740 PMCID: PMC9640258 DOI: 10.1097/jom.0000000000002663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of this study was to measure the association of working from home (WFH) with work productivity loss due to caregiving responsibilities or health problems during the COVID-19 pandemic. METHODS We conducted an online survey of family/friend caregivers (n = 150 WFH/75 non-WFH) and patients (n = 95/91) who worked during the past 7 days in May and July 2020, respectively. Absenteeism and presenteeism were measured using the Valuation of Lost Productivity questionnaire. RESULTS Working from home was associated with higher odds of absenteeism (odds ratio, 2.53; 95% confidence interval, 1.11 to 5.77) and presenteeism (2.79; 1.26 to 6.18) among caregivers and higher odds of presenteeism among patients (2.78; 1.13 to 6.84). However, among caregivers with absenteeism more than 0 days, WFH was significantly associated with fewer absent workdays. CONCLUSIONS Working from home was not associated with overall absenteeism and presenteeism in caregivers or patients. Working from home allows a more flexible and inclusive workplace without impacting productivity, although further research is needed.
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Kim D, Park JY, Lee DH, Lim JE, Moon HB, Kim S, Lee K. Simultaneous assessment of organophosphate flame retardants, plasticizers, trace metals, and house dust mite allergens in settled house dust. INDOOR AIR 2022; 32:e13071. [PMID: 35904395 DOI: 10.1111/ina.13071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/18/2022] [Accepted: 06/18/2022] [Indexed: 06/15/2023]
Abstract
Settled house dust (SHD) is a reservoir for various contaminants, including endocrine-disrupting chemicals (EDCs), trace metals, and house dust mite allergens. This study aimed to characterize various chemical and biological contaminants in SHD and identify determinants governing the indoor contaminants. In total, 106 SHD samples were collected from 106 houses in Seoul and Gyeonggi Province, Korea, in 2021. Bedding dust samples were collected from 30 of these 106 houses. All participants completed a questionnaire comprised of housing and lifestyle-related factors. The samples were analyzed for 18 organophosphate flame retardants (OPFRs), 16 phthalates, five alternative plasticizers (APs), seven trace metals, and two house dust mite allergens (Dermatophagoides farinae type 1 [Der f1] and Dermatophagoides pteronyssinus type 1 [Der p1]). A multiple regression analysis was conducted to identify the determinants governing the concentrations and profiles of various contaminants. OPFRs, phthalates, APs, and trace metals were detected in all SHD samples, indicating ubiquitous contamination in indoor environments. Among the three EDC groups, APs were detected at the highest concentrations (geometric mean [GM] (geometric standard deviation, [GSD]): 1452 (1.6) μg/g in total), followed by phthalates (GM (GSD): 676 (1.4) μg/g in total) and OPFRs (GM (GSD): 10 (1.4) μg/g in total). Der f1 was detected in all bedding dust samples with significantly higher levels than Der p1 (GM (GSD): 0.1 (1.8) μg/g vs. 1.4 × 10-3 (2.3) μg/g). The concentrations of OPFRs, plasticizers, and trace metals in SHD were significantly associated with the type and number of electronic appliances and combustion activities. Der f1 was significantly associated with the number of occupants and water penetration. Ventilation, vacuum cleaning, and wet cleaning or dry mopping significantly reduced the levels of most contaminants in SHD. As residents are persistently exposed to a wide array of pollutants, comprehensive and adequate measures are required to prevent potential exposures.
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Affiliation(s)
- Donghyun Kim
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Ji Young Park
- Institute of Health and Environment, Seoul National University, Seoul, South Korea
| | - Dong Hyun Lee
- Consulting & Technology for Environment Health and Safety, Seoul, South Korea
| | - Jae-Eun Lim
- Department of Marine Science and Convergence Engineering, College of Science and Convergence Technology, Hanyang University, Ansan, South Korea
| | - Hyo-Bang Moon
- Department of Marine Science and Convergence Engineering, College of Science and Convergence Technology, Hanyang University, Ansan, South Korea
| | - Sungkyoon Kim
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
- Institute of Health and Environment, Seoul National University, Seoul, South Korea
| | - Kiyoung Lee
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
- Institute of Health and Environment, Seoul National University, Seoul, South Korea
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Brouwer W, Huls S, Sajjad A, Kanters T, Roijen LHV, van Exel J. In Absence of Absenteeism: Some Thoughts on Productivity Costs in Economic Evaluations in a Post-corona Era. PHARMACOECONOMICS 2022; 40:7-11. [PMID: 34913141 PMCID: PMC8674022 DOI: 10.1007/s40273-021-01117-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 05/04/2023]
Affiliation(s)
- Werner Brouwer
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands.
| | - Samare Huls
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
| | - Ayesha Sajjad
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
| | - Tim Kanters
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
- Institute for Medical Technology Assessment (iMTA), Rotterdam, The Netherlands
| | - Leona Hakkaart-van Roijen
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
| | - Job van Exel
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
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