In the Journals

Informal caregiving costs for CVD projected to double by 2035

The cost for informal caregiving of patients with CVD is estimated to increase from $61 billion in 2015 to $128 billion in 2035, raising the forecasted total CVD costs to $616 billion in 2015 and $1.2 trillion in 2035, according to an American Heart Association policy statement published in Circulation.

“The dramatic rise in the prevalence of cardiovascular disease in the next 2 decades will place an intense strain on caregivers, putting their own health at risk from the ongoing distress, physical demands and cost,” Sandra B. Dunbar, RN, PhD, FAHA, adjunct professor of medicine, Charles Howard Candler professor of cardiovascular nursing and associate dean for academic advancement at Emory University School of Nursing, and chair of the writing group, said in a press release. “Our nation will ultimately bear the financial impact of this situation, especially as the caregiver pool shrinks.”

Health and Retirement Study data

Researchers estimated baseline costs for informal caregiving of patients with CVD through data from the 2014 Health and Retirement Study. The analysis included 16,731 patients aged at least 54 years, 46% of whom were men. Information from the survey included insurance coverage, physical and mental health, family support systems, financial status, retirement planning and labor market status.

The survey was also used for the prevalence of CVD, including angina, hypertension, congestive HF, MI, abnormal heart rhythm, stroke and other CV issues.

The number of patients who received informal caregiving was determined through several questions on the survey. Patients were also asked to quantify the number of hours per week they received informal caregiving and what activities of daily living they needed assistance with.

Researchers also calculated monetary value of informal caregiving and projections of costs of informal caregiving of CVD.

Informal caregiving for patients with stroke composed more than half the total costs of caring for patients with CVD, with $31 billion in 2015 and an estimated $66 billion in 2035.

Patients aged 65 to 79 years encountered the highest CVD informal caregiving costs in 2015 ($24 billion). By 2035, this patient population will surpass the costs for patients aged at least 80 years ($53 billion).

Eleven percent of productivity and medical costs for CVD were from informal caregiving for patients with CVD.

AHA recommendations

“Attention to the need for family-focused approaches and the development of sound caregiver policy are critical to ultimately reduce the burden of CVD,” Dunbar and colleagues wrote. “Collaboration among professional organizations, patient and family advocacy groups and policymakers could have a profound effect on changing this concerning landscape.”

For caregivers’ contributions to be compatible with quality care delivery, the AHA proposes four steps:

  • Develop and deploy a national caregiving strategy to address the needs of both the patient and the caregiver.
  • Expand palliative care access in community-based and hospital settings.
  • Incorporate outcomes and caregiver engagement in payment and performance reforms.
  • Prioritize caregiving research, specifically on quality of life, caregiver well-being and workforce productivity.

“Focused efforts to address the above four priorities will enable the United States to address the rising costs of informal caregiving while also offering needed caregiver education and support,” Dunbar and colleagues wrote. “The outcomes will be improved quality of life for patients with CVD and family caregivers and improved productivity of the workforce.”

“With the U.S. population growing older, the need for caregivers will accelerate considerably in the next 2 decades,” Nancy Brown, CEO of the AHA, said in the release. “We have no time to waste if we are to minimize the burden that will be placed on these Americans and their loved ones and wipe out the devastating economic and health impact of heart disease and stroke.” – by Darlene Dobkowski

Disclosures: Dunbar reports no relevant financial disclosures. Brown is an employee of the AHA. Please see the study for all other authors’ relevant financial disclosures.

Editor’s Note: This article was updated on April 19, 2018 to correct Dr. Dunbar’s title. The Editors regret the error.

The cost for informal caregiving of patients with CVD is estimated to increase from $61 billion in 2015 to $128 billion in 2035, raising the forecasted total CVD costs to $616 billion in 2015 and $1.2 trillion in 2035, according to an American Heart Association policy statement published in Circulation.

“The dramatic rise in the prevalence of cardiovascular disease in the next 2 decades will place an intense strain on caregivers, putting their own health at risk from the ongoing distress, physical demands and cost,” Sandra B. Dunbar, RN, PhD, FAHA, adjunct professor of medicine, Charles Howard Candler professor of cardiovascular nursing and associate dean for academic advancement at Emory University School of Nursing, and chair of the writing group, said in a press release. “Our nation will ultimately bear the financial impact of this situation, especially as the caregiver pool shrinks.”

Health and Retirement Study data

Researchers estimated baseline costs for informal caregiving of patients with CVD through data from the 2014 Health and Retirement Study. The analysis included 16,731 patients aged at least 54 years, 46% of whom were men. Information from the survey included insurance coverage, physical and mental health, family support systems, financial status, retirement planning and labor market status.

The survey was also used for the prevalence of CVD, including angina, hypertension, congestive HF, MI, abnormal heart rhythm, stroke and other CV issues.

The number of patients who received informal caregiving was determined through several questions on the survey. Patients were also asked to quantify the number of hours per week they received informal caregiving and what activities of daily living they needed assistance with.

Researchers also calculated monetary value of informal caregiving and projections of costs of informal caregiving of CVD.

Informal caregiving for patients with stroke composed more than half the total costs of caring for patients with CVD, with $31 billion in 2015 and an estimated $66 billion in 2035.

Patients aged 65 to 79 years encountered the highest CVD informal caregiving costs in 2015 ($24 billion). By 2035, this patient population will surpass the costs for patients aged at least 80 years ($53 billion).

Eleven percent of productivity and medical costs for CVD were from informal caregiving for patients with CVD.

AHA recommendations

“Attention to the need for family-focused approaches and the development of sound caregiver policy are critical to ultimately reduce the burden of CVD,” Dunbar and colleagues wrote. “Collaboration among professional organizations, patient and family advocacy groups and policymakers could have a profound effect on changing this concerning landscape.”

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For caregivers’ contributions to be compatible with quality care delivery, the AHA proposes four steps:

  • Develop and deploy a national caregiving strategy to address the needs of both the patient and the caregiver.
  • Expand palliative care access in community-based and hospital settings.
  • Incorporate outcomes and caregiver engagement in payment and performance reforms.
  • Prioritize caregiving research, specifically on quality of life, caregiver well-being and workforce productivity.

“Focused efforts to address the above four priorities will enable the United States to address the rising costs of informal caregiving while also offering needed caregiver education and support,” Dunbar and colleagues wrote. “The outcomes will be improved quality of life for patients with CVD and family caregivers and improved productivity of the workforce.”

“With the U.S. population growing older, the need for caregivers will accelerate considerably in the next 2 decades,” Nancy Brown, CEO of the AHA, said in the release. “We have no time to waste if we are to minimize the burden that will be placed on these Americans and their loved ones and wipe out the devastating economic and health impact of heart disease and stroke.” – by Darlene Dobkowski

Disclosures: Dunbar reports no relevant financial disclosures. Brown is an employee of the AHA. Please see the study for all other authors’ relevant financial disclosures.

Editor’s Note: This article was updated on April 19, 2018 to correct Dr. Dunbar’s title. The Editors regret the error.