Humanistic and economic burden among caregivers of patients with cancer in Japan

J Med Econ. 2020 Jan;23(1):17-27. doi: 10.1080/13696998.2019.1675672. Epub 2019 Oct 15.

Abstract

Aims: As the number of cancer patients increases in Japan, and people are living longer with cancer, the need for caregivers of cancer patients is expected to increase substantially. This study intended to reveal the humanistic and economic burden among caregivers of cancer patients, and to compare it with the burden among caregivers of patients with other conditions (other caregivers) and non-caregivers.Materials and methods: This cross-sectional analysis used data from the Japan National Health and Wellness Survey 2017. Outcome measures included the Short Form 12-item Health Survey for health-related quality of life (HRQoL), EuroQol 5-dimension scale (EQ-5D) for health states utilities, Work Productivity and Activity Impairment questionnaire for the impact of health on productivity and activity, and indirect costs. Multivariate analysis was used to compare across groups, with adjustment for potential confounding effects.Results: A total of 251 caregivers of cancer patients, 1,543 other caregivers, and 27,300 non-caregivers were identified. Caregivers of cancer patients (average 48.0 years old) tended to be younger than non-caregivers (51.5) and other caregivers (54.4) and had the highest education level (57.8% completed university education). Fewer non-caregivers had stress-related comorbidities than caregivers. Non-caregivers had significantly higher EQ-5D index scores than caregivers (average 0.81 vs. 0.73 vs. 0.74). Caregivers of cancer patients had significantly lower mental component summary scores than non-caregivers (40.18 vs. 46.70), and the difference indicated a clinically meaningful decrease in HRQoL. Caregivers of cancer patients had significantly higher presenteeism (37.31% vs. 20.43%), total work productivity impairment (38.85% vs. 21.98%), and activity impairment (40.94% vs. 25.78%) than non-caregivers. Additionally, caregivers of cancer patients had significantly higher total indirect costs (36.34% vs. 20.03% of average annual income).Conclusions: These results have implications for future healthcare planning, suggesting the importance of healthcare systems in Japan to consider the substantial burden borne by caregivers of cancer patients.

Keywords: Caregivers; I31; J24; Japan; cancer care; disease burden; quality of life; survey.

MeSH terms

  • Activities of Daily Living
  • Adult
  • Aged
  • Caregivers / economics*
  • Caregivers / psychology*
  • Comorbidity
  • Cross-Sectional Studies
  • Efficiency
  • Female
  • Health Status
  • Humans
  • Japan / epidemiology
  • Middle Aged
  • Models, Econometric
  • Neoplasms / epidemiology*
  • Quality of Life*
  • Socioeconomic Factors
  • Stress, Psychological / economics
  • Stress, Psychological / epidemiology