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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
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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
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Objectives: Validate a measure of work productivity loss due to caregiving Estimate the impact of informal caregiving on workplace productivity.
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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
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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)
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Impact on Work Productivity in Past 7 Days No Impairment at Work (48%) Impacted by Caregiving at Work (52%) Productive Time Presenteeism (35%) Absenteeism (9%) Employed Caregivers Work Time 38% Productivity loss for impacted caregivers 20% Productivity loss for all employed caregivers
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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
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Validation of WPAI-CG Productivity Loss WorkRegular Activity Depressionr=.23 p<.05 r=.27 p<.001 Caregiver Strain r=.41 p<.001 r=.59 p<.001
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Validation of WPAI-CG
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20% productivity loss National Impact Patients with no caregiver 6.1 Million Non-employed caregiver 1.9 Million Employed Caregiver 1.3 Million Productive Time Absenteeism 5% Presenteeism 19% Equivalent to 250,000 Full Time Employees Lost per Week 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
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Caregiving vs. Chronic Illness ConditionLost Work Time Lost Work Productivity Lost Regular Activity Productivity Caregiving5%14-28%21-33% Allergic Rhinitis020-40%20-50% IBS2.9-4.3 %21-32%24-41% GERD6%23%30% Chronic Hand Dermatitis 4%29%34% Panic1.9%26-29% Asthma2.4%14-28%21-41% Nocturnal GERD1.4%25.9%40.2%
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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 cost- effectiveness of employer based interventions
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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 erandgio@jhsph.edu
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