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      How much does it cost to care for survivors of colorectal cancer? Caregiver's time, travel and out-of-pocket costs.

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          Abstract

          Cancer treatment is increasingly delivered in an outpatient setting. This may entail a considerable economic burden for family members and friends who support patients/survivors. We estimated financial and time costs associated with informal care for colorectal cancer.

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          Economic valuation of informal care. An overview of methods and applications.

          Bernard M van den Berg, Werner Brouwer, Marc Koopmanschap (2004)
          Informal care makes up a significant part of the total amount of care provided to care recipients with chronic and terminal diseases. Still, informal care is often neglected in economic evaluations of health care programs. Probably this is related to the fact that the costs of informal care are to an important extent related to time inputs by relatives and friends of care recipients and time is not easy to value. Development of theoretically sound, yet easily applicable valuation methods is therefore important since ignoring the costs of informal care may lead to undesirable shifts between formal and informal care. Moreover, there is increasing evidence that providing informal care may lead to health problems for the caregiver, both in terms of morbidity and mortality. Until now these health effects have not been incorporated in economic evaluations. More attention for the identification and valuation of the full costs and (health) effects of informal care for the informal caregiver seems needed therefore. This contribution presents a critical evaluation of the available methods to incorporate informal care in economic evaluations.
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            Quality of life in patients with colorectal cancer 1 year after diagnosis compared with the general population: a population-based study.

            Christa Stegmaier, H Merx, Hermann Brenner … (2004)
            Quality of life (QOL) has become an important outcome measure for patients with cancer, but long-term results from population-based studies are rare. The objective of our study was to identify specific limitations of QOL in survivors of colorectal cancer in comparison with men and women from the general population 1 year after diagnosis when acute treatment effects are expected to have declined. QOL was assessed 1 year after diagnosis in a population-based cohort of 439 patients with colorectal cancer from Saarland (Germany) using the EORTC-QLC30 questionnaire. Specific functional and symptom QOL scores were compared with published reference data from the general population. Of 439 patients, 378 of them survived the first year after tumor diagnosis (86.1%). Of these, 309 returned the questionnaire (response rate, 81.7%). Compared with the general population, colorectal cancer patients scored their physical, role, cognitive, and global health functioning only slightly worse. More severe limitations were observed for the emotional and social functioning scales and for the symptom subscales of fatigue, dyspnea, insomnia, constipation, diarrhea, and financial difficulties. The differences regarding functional and symptom scores were predominantly found in younger age groups whereas older cancer patients and controls rated their health and QOL similarly. Deficits in emotional and social functioning and specific limitations like fatigue, dyspnea, insomnia, constipation, diarrhea, and financial difficulties are main factors hampering the QOL among colorectal cancer patients and seem to affect predominantly younger patients.
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              Time costs associated with informal caregiving for cancer survivors.

              Youngmee Kim, K Robin Yabroff (2009)
              To the authors' knowledge, little work has been done to estimate the time costs associated with informal caregiving for cancer survivors. Data from a national survey of caregivers of cancer patients in 2003 to 2006 were used to estimate the time associated with informal caregiving in the 2 years after patient diagnosis with bladder, breast, colorectal, kidney, lung, melanoma of the skin, ovarian, prostate, or uterine cancer, or non-Hodgkins lymphoma (NHL). Caregivers reported the duration and daily intensity of caregiving as well as the types and frequency of support provided. The median wage rate in 2006 ($16.28) was used to value caregiver time, and other methods to value time were evaluated with sensitivity analyses. On average, caregivers provided care for 8.3 hours per day for 13.7 months. The number of months and daily hours spent caregiving were the highest for cancer survivors diagnosed with distant disease compared with survivors with regional or localized disease (P<.05). Approximately half of caregivers provided emotional, instrumental, tangible, or medical support, although the frequency varied dramatically. Informal caregiver time costs over the 2-year period after diagnosis were the highest for caregivers of patients diagnosed with lung ($72,702; 95% confidence interval [95% CI], $56,814-$88,590) and ovarian ($66,210; 95% CI, $40,750-$91,670) cancers and NHL ($59,613; 95% CI, $43,423-$75,803) and the lowest for caregivers of patients with breast cancer ($38,334; 95% CI, $31,442-$45,226). Time spent by informal caregivers was substantial and was an important component of the burden of cancer care. Incorporation of the value of informal caregiver time will be important when evaluating the costs and benefits of cancer control interventions. Copyright (c) 2009 American Cancer Society.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Support Care Cancer
                Title: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
                Publisher: Springer Nature
                ISSN (Electronic): 1433-7339
                ISSN (Print): 0941-4355
                Publication date (Electronic): Sep 2013
                Volume: 21
                Issue: 9
                Affiliations
                [1 ] National Cancer Registry Ireland, Cork Airport Business Park, Kinsale Road, Cork, Ireland. paul.hanly@ncirl.ie
                Article
                DOI: 10.1007/s00520-013-1834-3
                PubMed ID: 23649879
                SO-VID: 70a2a37c-e13e-46dd-bec7-df8728aafc18
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