Transcript The Effect of Informal Caregiving on Work Productivity

The Effect of Informal Caregiving
on Work Productivity
Erin Rand-Giovannetti, Jennifer L. Wolff, Ph.D.,
Kevin D. Frick, Ph.D., Chad Boult, MD, MPH, MBA
Presented by: Erin Rand-Giovannetti
9:45am, June 9, 2008
Supported by the John A. Hartford Foundation,
the Agency for Healthcare Research and Quality,
the National Institute on Aging, and
the Jacob and Valeria Langeloth Foundation
Background
• Majority of long-term care provided by families
• Informal caregiving may influence employment
 Missed work time – Absenteeism
 Reduced productivity – Presenteeism
• Measurement Issues
 Limited generalizability
 Lack of appropriate presenteeism/absenteeism
measurement tool
Objectives:
• Validate a measure of work productivity loss due to
caregiving
• Estimate the impact of informal caregiving on
workplace productivity.
Methods: Study Sample
• Guided Care Study
 308 Caregiver/Patient Dyads
 Patients age 65+ in top quartile of risk of health service use
• 55% female
• Mean age = 79
 Primary caregiver assists with health tasks
• 71% female
• Mean age = 61
• 45% adult children
• Mean hours of care a week = 25
• 61% helped daily
Methods: Work Productivity and
Activity Impairment Scale (WPAI-CG)
• Are you currently employed?
 40% yes
• During the past 7 days how many hours did you miss
from work because of your caregiving?
 1.5 hours (4.9% of work time)
• On a scale of 0 to 10, during the past 7 days, how
did your caregiving affect your productivity while
you were at work?
 1.8 (18% reduction in work productivity)
Impact on Work Productivity in
Past 7 Days
Employed Caregivers
Work Time
No
Impairment
at Work
(48%)
Impacted by
Caregiving
at Work
(52%)
Absenteeism
(9%)
38% Productivity
loss for impacted
caregivers
Productive
Time
Presenteeism
(35%)
20% Productivity
loss for all
employed
caregivers
Impact on Regular Activities in Past
7 Days
• On a scale of 0 to 10, during the past 7 days, how
did your caregiving affect your ability to do your
daily activities?
• 60% reported some impairment
• 27% productivity loss
Validation of WPAI-CG
Productivity Loss
Work
Regular
Activity
Depression
r=.23
p<.05
r=.27
p<.001
Caregiver
Strain
r=.41
p<.001
r=.59
p<.001
Validation of WPAI-CG
National Impact
Policy Level
All High-Risk Medicare Patients
9.3 Million (25% of 37 Million)
Employer Level
Work Time of Caregivers to
High-Risk Medicare Patients
Absenteeism 5%
20%
productivity
loss
Non-employed
caregiver
1.9 Million
Employed
Caregiver
1.3 Million
Patients with
no caregiver
6.1 Million
Presenteeism
19%
Productive
Time
Equivalent to 250,000
Full Time Employees
Lost per Week
Caregiving vs. Chronic Illness
Condition
Lost Work
Time
Lost Work
Productivity
Caregiving
Allergic Rhinitis
IBS
5%
0
2.9-4.3 %
14-28%
20-40%
21-32%
Lost Regular
Activity
Productivity
21-33%
20-50%
24-41%
GERD
Chronic Hand
Dermatitis
6%
4%
23%
29%
30%
34%
Panic
1.9%
26-29%
Asthma
Nocturnal GERD
2.4%
1.4%
14-28%
25.9%
21-41%
40.2%
Conclusions
• The WPAI-CG is a valid for measuring productivity
loss due to informal caregiving.
• The WPAI-CG is sensitive to care-recipient medical
complexity
 Work productivity loss ranges from 14%-28%
 Regular activity productivity loss ranges from 21-33%
• Impact of caregiving is comparable to impact of
chronic illness
• WPAI-CG is a valuable tool for measuring costeffectiveness of employer based interventions
Acknowledgements
• The guided care team (Sara Palmer, Lisa Reider, Katherine Frey and
Tracy Novak)
• Johns Hopkins Community Physicians
• MedStar
• Battelle Centers for Public Health Research
• The Centers for Medicare & Medicaid Services
• Kaiser Permanente
• Accumen
• ResDAC
• The University of Minnesota Survey Research Center
• The study consultants (Jean Giddens, RN, PhD; Kate Lorig, RN, DrPH;
Richard Bohmer, MD, MPH, MBA; Mary Naylor, RN, PhD),
• The nurse managers (Lora Rosenthal and Carol Groves),
• All of the participating patients, caregivers, physicians, and Guided
Care nurses.
Please contact Erin Rand-Giovannetti with questions
[email protected]