Caregiver preferences and willingness-to-pay for home care services for older people with dementia: A discrete choice experiment in the Milan metropolitan area.

IF 3.6 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Health Policy Pub Date : 2025-02-01 Epub Date: 2024-12-03 DOI:10.1016/j.healthpol.2024.105220

Michela Meregaglia, Simone Manfredi, Eleonora Perobelli, Andrea Rotolo, Elisabetta Donati, Elisabetta Notarnicola

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引用次数: 0

Abstract

Objectives: Dementia is a major health and social care challenge in high-income countries where most people are cared for in their own homes. This study aimed to elicit caregiver preferences for alternative bundles of home care services in the Milan metropolitan area.

Methods: A binary discrete choice experiment was administered to a sample of informal caregivers of people with dementia recruited through a network of non-profit organizations. The experiment included four attributes: 1) number of home care hours per month; 2) type of care; 3) caregiver peer support group organization; 4) monthly family's cost (in euros), each articulated into three levels. A mixed logit model was applied to analyze the responses using Stata.

Results: A total of 93 self-administered questionnaires were collected in January-April 2023. Two-thirds of both caregivers (67.7 %) and care recipients (65.6 %) were female, with a mean age of 59.0 (±12.1) years and 82.2 (±6.5) years, respectively. The experiment showed that increased home care hours, mixed health and social home care, caregiver meetings with professional support and lower monthly costs were mostly valued by caregivers. Some preference heterogeneity was detected in relation to care recipient's characteristics (e.g., age).

Conclusions: These results are expected to inform policymakers about caregiver priorities in the field of dementia based on the values placed on hypothetical public home care services.

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照顾者对老年痴呆症患者家庭护理服务的偏好和支付意愿：米兰大都会地区的离散选择实验。

在高收入国家，痴呆症是一项重大的卫生和社会保健挑战，在这些国家，大多数人都在自己家中接受护理。本研究的目的是引出照顾者的选择，在米兰大都市区的家庭护理服务捆绑包。方法：通过非营利性组织网络招募的痴呆症患者的非正式照顾者样本进行二元离散选择实验。实验包括四个属性：1)每月家庭护理小时数；2)护理类型；3)护理同伴支持小组组织；4)每月家庭开销（以欧元计），每个都分为三个层次。采用混合logit模型，利用Stata对响应进行分析。结果：在2023年1 - 4月共收集到93份自填问卷。三分之二的照护者（67.7%）和接受照护者（65.6%）为女性，平均年龄分别为59.0（±12.1）岁和82.2（±6.5）岁。实验表明，增加家庭护理时间、混合健康和社交家庭护理、有专业支持的护理人员会议以及降低每月费用是护理人员最看重的。一些偏好异质性被发现与照顾者的特征（如年龄）有关。结论：这些结果有望根据假设的公共家庭护理服务的价值，为决策者提供有关痴呆症领域护理人员优先事项的信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Policy 医学-卫生保健

CiteScore

6.40

自引率

6.10%

发文量

157

审稿时长

3-8 weeks

期刊介绍： Health Policy is intended to be a vehicle for the exploration and discussion of health policy and health system issues and is aimed in particular at enhancing communication between health policy and system researchers, legislators, decision-makers and professionals concerned with developing, implementing, and analysing health policy, health systems and health care reforms, primarily in high-income countries outside the U.S.A.