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Long- term cost of spouses’ informal support for dependent midlife stroke survivors

Journal article
Authors Josefine Persson
Lars-Åke Levin
Lukas Holmegaard
Petra Redfors
Mikael Svensson
Katarina Jood
Christina Jern
Christian Blomstrand
Gunilla Forsberg-Wärleby
Published in Brain and Behavior
Volume 7
Issue 6
ISSN 2162-3279
Publication year 2017
Published at Institute of Biomedicine, Department of Medical and Clinical Genetics
Institute of Neuroscience and Physiology
Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics
Language en
Keywords cost and cost analysis, informal support, opportunity cost, stroke, time costs, time-diary
Subject categories Neurology, Health Care Service and Management, Health Policy and Services and Health Economy


Objectives: Stroke is a major global disease that requires extensive care and support from society and relatives. The aim of this study was to identify and quantify the long- term informal support and to estimate the annual cost of informal support provided by spouses to their stroke surviving partner. Method: Data were based on the 7- year follow- up of the Sahlgrenska Academy Study on Ischemic Stroke. One- third of the spouses stated that they provided support to their stroke surviving partner. The magnitude of the support was assessed with a study- specific time- diary and was estimated for independent and dependent stroke survivors based on the scores of the modified Rankin Scale. To deal with skewed data, a two- part econometric model was used to estimate the annual cost of informal support. Result: Cohabitant dyads of 221 stroke survivors aged <70 at stroke onset were in- cluded in the study. Spouses of independent stroke survivors ( n = 188) provided on average 0.15 hr/day of practical support and 0.48 hr/day of being available. Corresponding figures for spouses of dependent stroke survivors ( n = 33) were 5.00 regarding practical support and 9.51 regarding being available. The mean annual cost of informal support provided for independent stroke survivors was estimated at €991 and €25,127 for dependent stroke survivor. Conclusion: The opportunity cost of informal support provided to dependent midlife stroke survivors is of a major magnitude many years after stroke onset and should be considered in economic evaluations of health care.

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