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RESEARCH ARTICLE |
a Division of General Medicine, Department of Medicine, University of Michigan, Ann Arbor
b Department of Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan
c Institute for Social Research, University of Michigan, Ann Arbor
d Economic Modeling Core, Michigan Diabetes Research and Training Center, University of Michigan, Ann Arbor
e Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor
f Consortium for Health Outcomes, Innovation, and Cost-Effectiveness Studies (CHOICES), University of Michigan, Ann Arbor
g Division of Geriatric Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor
Kenneth M. Langa, Division of General Medicine, Department of Medicine, University of Michigan Health System, 300 North Ingalls Building, Room 7E01, Box 0429, Ann Arbor, MI 48109-0429 E-mail: klanga{at}umich.edu.
Decision Editor: Fredric D. Wolinsky, PhD
Objectives. Little is known regarding the amount of time spent by unpaid caregivers providing help to elderly individuals for disabilities associated with diabetes mellitus (DM). We sought to obtain nationally representative estimates of the time, and associated cost, of informal caregiving provided to elderly individuals with diabetes, and to determine the complications of DM that contribute most significantly to the subsequent need for informal care.
Methods. We estimated multivariable regression models using data from the 1993 Asset and Health Dynamics Among the Oldest Old Study, a nationally representative survey of people aged 70 or older (N = 7,443), to determine the weekly hours of informal caregiving and imputed cost of caregiver time for community-dwelling elderly individuals with and without a diagnosis of DM.
Results. Those without DM received an average of 6.1 hr per week of informal care, those with DM taking no medications received 10.5 hr, those with DM taking oral medications received 10.1 hr, and those with DM taking insulin received 14.4 hr of care (p < .01). Disabilities related to heart disease, stroke, and visual impairment were important predictors of diabetes-related informal care. The total cost of informal caregiving for elderly individuals with diabetes in the United States was between $3 and $6 billion per year, similar to previous estimates of the annual paid long-term care costs attributable to DM.
Discussion. Diabetes imposes a substantial burden on elderly individuals, their families, and society, both through increased rates of disability and the significant time that informal caregivers must spend helping address the associated functional limitations. Future evaluations of the costs of diabetes, and the cost-effectiveness of diabetes interventions, should consider the significant informal caregiving costs associated with the disease.
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