Productivity loss and resource utilization, and associated indirect and direct costs in individuals providing care for adults with schizophrenia in the EU5

Abstract

Objective

This study aimed to understand the impact of providing care for adults with schizophrenia on productivity, resource utilization, and costs in the EU5 (France, Germany, Italy, Spain, and UK).

Methods

Data from the 2010, 2011, and 2013 EU5 National Health and Wellness Survey, an online questionnaire of a nationwide sample of adults, were analyzed. Schizophrenia caregivers (n=398) were matched to noncaregivers (n=158,989) and other caregivers (n=14,341) via propensity scores. Outcome measures included health care utilization, Work Productivity and Activity Impairment questionnaire-based scores, and associated direct and indirect costs (estimated from the literature). Significant differences between schizophrenia caregivers vs noncaregivers and other caregivers (eg, cancer and Alzheimer’s disease) were examined.

Results

After matching, schizophrenia caregivers reported greater activity impairment (38.4% vs 26.1%), provider visits (8.0 vs 5.7), emergency room visits (0.9 vs 0.2), hospitalizations (0.8 vs 0.1), and direct costs (€2,258 vs €617) than noncaregivers, all P<0.001. Employed schizophrenia caregivers reported greater absenteeism, presenteeism, overall work impairment (35.0% vs 20.7%), and indirect costs (€6,667 vs €3,795) than noncaregivers, all P<0.001. Schizophrenia caregivers (vs other caregivers) reported greater activity impairment (38.4% vs 32.3%) and provider visits (8.0 vs 6.6), P<0.05. A greater proportion of schizophrenia caregivers (vs other caregivers) reported at least one emergency room visit (26.1% vs 20.2%) and hospitalization (20.4% vs 14.3%), P<0.05. Employed schizophrenia caregivers incurred greater indirect costs than other caregivers (€6,667 vs €5,104).

Discussion

Schizophrenia caregivers reported greater activity impairment, resource utilization, and costs than noncaregivers and other caregivers. Better support systems for schizophrenia caregivers may help reduce the burden on the health care system and caregivers.

Keywords:

• schizophrenia
• caregiver
• direct cost
• indirect cost
• resource utilization
• productivity loss
• physician visits
• burden
• emergency room
• hospitalization

Acknowledgments

The authors acknowledge the background research and editorial assistance of Errol J Philip, a paid consultant to Kantar Health. Portions of this study were presented as a poster at the International Society of Pharmacoeconomics and Outcomes Research Annual European Congress 2014 in Amsterdam RAI, Amsterdam, the Netherlands: “Productivity Loss and Resource Utilization in Individuals Providing Care for Adults with Schizophrenia in the 5EU”. The poster abstract was published in Value in Health, Volume 17, Issue 7, A457: http://dx.doi.org/10.1016/j.jval.2014.08.1255.

Disclosure

S Gupta and G Isherwood are employees of Kantar Health, who were paid consultants to Janssen-Cilag in connection with the study design, analysis and interpretation of data, writing of the article, and the publication submission decision. K Van Impe is an employee of Janssen-Cilag, who funded the study and provided direction into the study design, analysis and interpretation of data, writing of the article, and the publication submission decision. K Jones holds a consultancy role with Janssen-Cilag and is an employee of the European Federation of Associations of Families of People with Mental Illness, who endorsed the study, provided expert insight into the study design, analysis and interpretation of data, reviewed the writing of the article, and provided insights on the publication submission decision. The authors report no other conflicts of interest in this work.