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Caregiver credits in France, Germany, and Sweden: lessons for the United States.

https://arctichealth.org/en/permalink/ahliterature128551
Source
Soc Secur Bull. 2011;71(4):61-76
Publication Type
Article
Date
2011
Author
John Jankowski
Author Affiliation
Division of Program Studies, Office of Research, Evaluation, and Statistics, Office of Retirement and Disability Policy, Social Security Administration, USA.
Source
Soc Secur Bull. 2011;71(4):61-76
Date
2011
Language
English
Publication Type
Article
Keywords
Age Factors
Caregivers - economics - statistics & numerical data
Cross-Cultural Comparison
Employment - economics - standards - statistics & numerical data
Female
France
Germany
Humans
Pensions - statistics & numerical data
Poverty
Sex Factors
Social Security - standards - statistics & numerical data
Sweden
United States
Women
Abstract
Recently, analysts in the United States (US) have proposed adopting caregiver credits, or pension credits, provided to individuals for time spent out of the workforce while caring for dependent children and sick or elderly relatives. The primary objective of these credits, used in almost all public pension systems in the European Union, is to improve the adequacy of old-age benefits for women whose gaps in workforce participation typically lead to fewer years of contributions, lower lifetime average earnings, and consequently lower pensions. This article examines caregiver credits in the context of future reforms to the US Social Security system, with attention given to the adequacy of current spouse and survivor benefits and how changing marital patterns and family structures have increased the risk of old-age poverty among certain groups of women. It then analyzes caregiver credit programs in selected countries, with particular focus on design, administration, and cost.
PubMed ID
22191285 View in PubMed
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Do they care too much to work? The influence of caregiving intensity on the labour force participation of unpaid caregivers in Canada.

https://arctichealth.org/en/permalink/ahliterature140548
Source
J Health Econ. 2010 Dec;29(6):895-903
Publication Type
Article
Date
Dec-2010
Author
Meredith B Lilly
Audrey Laporte
Peter C Coyte
Author Affiliation
Department of Economics and Centre for Health Economics and Policy Analysis, McMaster University, Kenneth Taylor Hall, Rm 426, 1280 Main Street West, Hamilton, ON, L8S 4M4, Canada. meredith.lilly@utoronto.ca
Source
J Health Econ. 2010 Dec;29(6):895-903
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Canada
Caregivers - economics - statistics & numerical data
Cohort Studies
Employment - statistics & numerical data
Female
Home Nursing
Humans
Male
Middle Aged
Abstract
The recent growth of the home care sector combined with societal and demographic changes have given rise to concerns about the adequacy of the supply of family and friend caregivers. Potential caregivers face competing time pressures that pull them in the direction of the labour market on one hand, and towards unpaid caregiving duties on the other. This paper examines the influence of unpaid caregiving on the labour supply of a cohort of working-aged caregivers in Canada, with particular emphasis on caregiving intensity. Results suggest that caregivers are heterogeneous in both their caregiving inputs and associated labour market responses, thereby underscoring the importance of controlling for caregiving intensity when measuring labour supply. The negative influence of primary caregiving on labour supply appears to be at the level of labour force participation, rather than on hours of work or wages.
PubMed ID
20864197 View in PubMed
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The fiscal impact of informal caregiving to home care recipients in Canada: how the intensity of care influences costs and benefits to government.

https://arctichealth.org/en/permalink/ahliterature116931
Source
Soc Sci Med. 2013 Mar;81:102-9
Publication Type
Article
Date
Mar-2013
Author
Josephine C Jacobs
Meredith B Lilly
Carita Ng
Peter C Coyte
Author Affiliation
Institute of Health Policy, Management, and Evaluation, University of Toronto, 155 College St., Toronto, Canada M5T 3M6. jo.jacobs@mail.utoronto.ca
Source
Soc Sci Med. 2013 Mar;81:102-9
Date
Mar-2013
Language
English
Publication Type
Article
Keywords
Canada
Caregivers - economics - statistics & numerical data
Cost-Benefit Analysis
Cross-Sectional Studies
Employment - economics
Federal Government
Female
Home Nursing - economics - statistics & numerical data
Humans
Income Tax - economics
Male
Middle Aged
Social Welfare - economics
Time Factors
Abstract
The objective of this study was to estimate the annual costs and consequences of unpaid caregiving by Canadians from a government perspective. We estimated these costs both at the individual and population levels for caregivers aged 45 and older. We conducted a cost-benefit analysis where we considered the costs of unpaid caregiving to be potential losses in income tax revenues and changes in social assistance payments and the potential benefit of reduced paid care expenditures. Our costing methods were based on multivariate analyses using the 2007 General Social Survey, a cross-sectional survey of 23,404 individuals. We determined the differential probability of employment, wages, and hours worked by caregivers of varying intensity versus non-caregivers. We also used multivariate analysis to determine how receiving different intensities of unpaid care impacted both the probability of receiving paid care and the weekly hours of paid care received. At the lowest intensities of caregiving, there was a net benefit to government from caregiving, at both the individual and population levels. At the population level, the net benefit to government was estimated to be $4.4 billion for caregivers providing less than five hours of weekly care. At the highest intensity of caregiving, there was a net cost to government of $641 million. Our overall findings were robust to a number of changes applied in our sensitivity analysis. We found that the factor with the greatest impact on cost was the probability of labour force participation. As the biggest cost driver appears to be the higher likelihood of intense caregivers dropping out of the labour force, government policies that enable intense caregivers to balance caregiving with employment may help to mitigate these losses.
PubMed ID
23347496 View in PubMed
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Older women: work and caregiving in conflict? A study of four countries.

https://arctichealth.org/en/permalink/ahliterature97910
Source
Soc Work Health Care. 2009 Oct;48(7):665-95
Publication Type
Article
Date
Oct-2009
Author
Charlotte Muller
Oleg Volkov
Author Affiliation
Doctoral Program in Economics, Cuny Graduate Center, New York, NY 10016, USA. charmullscho@gmail.com
Source
Soc Work Health Care. 2009 Oct;48(7):665-95
Date
Oct-2009
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Age Factors
Aged
Aged, 80 and over
Aging
Caregivers - economics - statistics & numerical data
Europe
Female
Financing, Government - organization & administration - statistics & numerical data
Health status
Humans
Male
Middle Aged
Population Dynamics
Public Policy
Sex Factors
Socioeconomic Factors
United States
Women's health
Women, Working - statistics & numerical data
Abstract
Caregiving issues are important for industrialized societies that have been undergoing population aging. In this article we consider caregiving as a factor in the outlook for midlife and older women with respect to economic security and economic advancement. We use demographic and economic data from the United States, France, Sweden, and the United Kingdom, in particular to document the importance of continued labor force participation for older women to make ends meet in an era of high household costs of physician services, prescription drugs, and other health-related services, and uncertainties about pensions. Data on employment status, industry, and occupation of economically active women in comparison with men indicate the extent of both gender gaps and progress affecting women's resources. The research of Dr. Myrna Lewis was a stimulus to the present exploration. Our conclusion discusses the implications for women's welfare of policy initiatives relating to care of elderly disabled, including improving services to family caregivers, assuring social financing of formal care, raising local provisions to a national standard, and supporting women's return to the labor force after a period of caregiving. In the context of population aging and longevity, such initiatives are responsive to women's need for earned income to attain retirement security.
PubMed ID
20182981 View in PubMed
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Spatially informed knowledge translation: informing potential users of Canada's Compassionate Care Benefit.

https://arctichealth.org/en/permalink/ahliterature150191
Source
Soc Sci Med. 2009 Aug;69(3):411-9
Publication Type
Article
Date
Aug-2009
Author
Melissa Giesbrecht
Valorie A Crooks
Nadine Schuurman
Allison Williams
Author Affiliation
Department of Geography, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia, Canada.
Source
Soc Sci Med. 2009 Aug;69(3):411-9
Date
Aug-2009
Language
English
Publication Type
Article
Keywords
Aged
Awareness
Canada
Caregivers - economics - statistics & numerical data
Data Collection
Diffusion of Innovation
Evidence-Based Medicine
Female
Geography
Government Programs - economics - statistics & numerical data
Health Knowledge, Attitudes, Practice
Health Services Research
Humans
Information Dissemination
Male
Middle Aged
Qualitative Research
Abstract
Implemented in 2004 by the Canadian government, the Compassionate Care Benefit (CCB) program aims to provide income assistance and job security to caregivers who decide to take temporary leave from their employment to care for a terminally ill family member at risk of dying. Reports have cited numerous challenges with respect to the benefit's successful uptake, including the major obstacle of a general lack of awareness regarding the program's existence. Based on this knowledge, the present analysis aims to consider local contexts and potential barriers through engagement with the knowledge-to-action (KTA) cycle. Using an innovative and spatially informed three-step mixed-method analysis, we identify: (1) who likely CCB-eligible family caregivers are; (2) where these individuals' households are located; and (3) how best to get information about the CCB to them. Melding the findings from the three analytic steps generates a tailored path from which an information dissemination strategy can be guided (the intended action). Results indicate that targeted dissemination efforts undertaken outside of urban cores are likely to be most efficient in reaching potential or current CCB-eligible family caregivers. This strategy should be implemented through multiple formats and venues via two information pathways: (1) from key professionals to family caregivers and (2) from the community to the general public. Through employing a spatial perspective, these findings engage and usefully contribute to the KTA cycle process. Future involvement in the cycle will entail translating these findings for use in a decision-making context in order to implement an intervention. This approach can also be applied to other health and social programs where lack of awareness exists or for targeted interventions that require identifying specific populations.
PubMed ID
19540645 View in PubMed
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Willingness-to-pay for reductions in care need: estimating the value of informal care in Alzheimer's disease.

https://arctichealth.org/en/permalink/ahliterature148583
Source
Int J Geriatr Psychiatry. 2010 Jun;25(6):622-32
Publication Type
Article
Date
Jun-2010
Author
Anders Gustavsson
Linus Jönsson
Rupert McShane
Mercè Boada
Anders Wimo
Arthur S Zbrozek
Author Affiliation
Department of Neurobiology, Care Sciences and Society, Alzheimers Disease Research Center, Karolinska institutet, Novum plan 5, Stockholm, Sweden. anders.gustavsson@ki.se
Source
Int J Geriatr Psychiatry. 2010 Jun;25(6):622-32
Date
Jun-2010
Language
English
Publication Type
Article
Keywords
Aged
Alzheimer Disease - diagnosis - economics - nursing
Caregivers - economics - statistics & numerical data
Cost of Illness
Female
Financing, Personal - economics
Great Britain
Health Services Research - economics
Humans
Income
Male
Middle Aged
Patient Acceptance of Health Care
Questionnaires
Severity of Illness Index
Spain
Sweden
United States
Abstract
To estimate the value of informal care in Alzheimer's disease using contingent valuation.
A questionnaire was administered to 517 primary carers in four countries (UK, Spain, Sweden, and US). Dichotomous choice and bidding game methods were used to elicit their willingness to pay for a reduction in care burden by 1 h per day, or a total elimination of care needs. Further, the relationship between carer willingness to pay and carer and patient characteristics including disease severity and income was examined.
Carers spend on average about 7-9 h per day on giving care to their patient, of which 4-5 h constituted basic and instrumental ADL tasks. For a 1 h reduction in need for care per day, carers in the UK, Spain, Sweden, and US said that they were willing to pay pound105, pound121, pound59, and pound144 per month respectively. The willingness to pay was higher for carers with higher disposable income while the influence of other determinants varied across countries. About one-third of carers were not willing to pay anything for a reduction in care.
Carers' stated willingness to pay for reductions in care giving time is substantial and comparable to the prices currently paid for treatments that achieve this benefit. Its determinants seem more directly related to carer status than directly to patient status and may vary by region and by cultural and sociologic factors.
PubMed ID
19750558 View in PubMed
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6 records – page 1 of 1.