Caring for and caring about: Disentangling the caregiver effect and the family effect

Bobinac, Ana; Exel, Job van; Rutten, Frans; Brouwer, Werner

doi:10.1016/j.jhealeco.2010.05.003

Cited by 180 publications

(209 citation statements)

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“…This is also the case in those models that seek to account for welfare beyond the physicianpatient relation (for example, Bobinac, et al, 2010;Burge, et al, 2010;Lilly, et al, 2010). …”

Section: Problems: An Inadequate Treatment Of Care?mentioning

confidence: 94%

“…Although they do not refer explicitly to social capital, Bobinac et al's (2010) model of informal care is informative in that it seeks to expand health economics beyond its principal focus on the physician-as-carer by using the standard externality account. Those close to an ill individual benefit from improvements to this individual's health status by virtue of their relationship to that individual -"the significant other(s)".…”

Section: Care As Social Capitalmentioning

confidence: 99%

“…It explains behavior as constrained utility maximization, and takes a consequentialist approach to the valuation of care (see, for example, Forget 2004;Glied and Smith 2011). Health care is seen as being supplied primarily by medical professionals (Mooney, 2009), and since Arrow's seminal article (1963) the care relationship has been explained in terms of interdependent utility functions and principal-agent relationships between clinicians and patients (McGuire, et al 1982), between "significant others" and patients (Bobinac, et al 2010), between the wider population and those who are ill (Culyer 1976), and in terms of dual utility functions (Wiseman, 1997;Mooney 2009). Distributional issues enter in terms of the idea of merit goods (for example, Tuohy and Glied 2011).…”

Section: Introductionmentioning

confidence: 99%

“…In this regard, health economists' understanding of care draws from Gary Becker's (1976) work extending the "economic approach" to the social domain that uses standard analytical tools to re-interpret interactions within the family, addiction, health, and crime in utility maximization terms (for example , Becker 2007;Bobinac, et al 2010;see also, Fine 1999). …”

Section: Introductionmentioning

confidence: 99%

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Situating Care in Mainstream Health Economics: An Ethical Dilemma?

Davis

McMaster

2014

SSRN Journal

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Standard health economics concentrates on the provision of care by medical professionals. Yet 'care' receives scant analysis; it is portrayed as a spillover effect or externality in the form of interdependent utility functions. In this context care can only be conceived as either acts of altruism or as social capital. Both conceptions are subject to considerable problems stemming from mainstream health economics' reliance on a reductionist social model built around instrumental rationality and consequentialism. Subsequently, this implies a disregard for moral rules and duties and the compassionate aspects of behaviour. Care as an externality is a secondorder concern relative to self-interested utility maximization, and is therefore crowded out by the parameters of the standard model. We outline an alternative relational approach to conceptualising care based on the social embeddedness of the individual that emphasises the ethical properties of care. The deontological dimension of care suggests that standard health economics is likely to undervalue the importance of care and caring in medicine.

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“…This is also the case in those models that seek to account for welfare beyond the physicianpatient relation (for example, Bobinac, et al, 2010;Burge, et al, 2010;Lilly, et al, 2010). …”

Section: Problems: An Inadequate Treatment Of Care?mentioning

confidence: 94%

Section: Care As Social Capitalmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Situating Care in Mainstream Health Economics: An Ethical Dilemma?

Davis

McMaster

2014

SSRN Journal

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“…This presumably is a more objective measure of the dependent's person health because the assessment is conducted by medical professionals. By entering the dependent's person health, we are also able to control for the so-called family effect of informal care (Bobinac et al, 2010). Having a family member with health problems may also adversely influence the psychological well-being of household members who are not the primary caregiver.…”

Section: Sensitivity Analysismentioning

confidence: 99%

Caring Alone? Social Capital and the Mental Health of Caregivers

Thiel

2016

SSRN Journal

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in SOEPpapers on Multidisciplinary Panel Data Research at DIW BerlinThis series presents research findings based either directly on data from the German SocioEconomic Panel study (SOEP) or using SOEP data as part of an internationally comparable data set (e.g. CNEF, ECHP, LIS, LWS, CHER/PACO). SOEP is a truly multidisciplinary household panel study covering a wide range of social and behavioral sciences: economics, sociology, psychology, survey methodology, econometrics and applied statistics, educational science, political science, public health, behavioral genetics, demography, geography, and sport science.The decision to publish a submission in SOEPpapers is made by a board of editors chosen by the DIW Berlin to represent the wide range of disciplines covered by SOEP. There is no external referee process and papers are either accepted or rejected without revision. Papers appear in this series as works in progress and may also appear elsewhere. They often represent preliminary studies and are circulated to encourage discussion. Citation of such a paper should account for its provisional character. A revised version may be requested from the author directly.Any opinions expressed in this series are those of the author(s) and not those of DIW Berlin.Research disseminated by DIW Berlin may include views on public policy issues, but the institute itself takes no institutional policy positions. AbstractThis study analyzes the role of social capital in buffering the negative relationship between informal-care provision and mental health. Using data from the German Socio-Economic Panel (SOEP) and fixed-effect regression models, we show that those individuals who socialize more frequently enjoy better mental health. We also find that stronger social ties moderate the negative association between caregiving and mental well-being. The protective role of social capital appears to be particularly strong for caregivers with high time commitments or those who regularly perform voluntary work. The moderating role of social activities can neither be explained by the caregiver's observed characteristics correlated with social capital, nor by features of the caregiving process. However, the results might be driven by insufficient overlap in covariates between carers and non-carers, and the simultaneity between caring decisions and social activities. We relate our results to recent policy initiatives that aim to improve the carer's well-being. U...

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Association Between New-Onset Medicaid Home Care and Family Caregivers’ Health

et al. 2021

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IMPORTANCE More than 17 million people in the US provide uncompensated care for adults with physical or cognitive limitations. Such caregiving is associated with worse mental and physical health, yet little research has investigated how publicly funded home care might ameliorate these harms. OBJECTIVE To investigate the association between Medicaid home care services and family caregivers' health. DESIGN, SETTING, AND PARTICIPANTS This longitudinal cohort study used data from the 1996 to 2017 Medical Expenditures Panel Survey. Data on all household members were collected in 5 interviews over 2 years. Person-level difference-in-difference models were used to isolate withinperson changes associated with new onset of Medicaid home care. The Medical Expenditures Panel Survey longitudinal data sets included 331 202 individuals (approximately 10% excluded owing to loss to follow-up). Adult (age Ն21 years) members of households that contained at least 1 person with limited activities of daily living were included in our study. The analysis itself was performed from March to August of 2020. EXPOSURES New onset of regular (Ն1 time per month) Medicaid home care in the household.MAIN OUTCOMES AND MEASURES Self-rated mental and physical health (planned prior to beginning the study). RESULTSThe study population was 14 013 adults; 7232 were "likely caregivers," or nondisabled adult coresidents of someone with activities of daily living limitations. Overall, 962 likely caregivers were ever exposed to Medicaid home care in the household; for 563, we observed the onset. Of likely caregivers exposed to Medicaid home care, 479 (50%) were women; 296 (31%) were White non-Hispanic, 309 (31%) were Hispanic or Latinx, and 279 (29%) were Black non-Hispanic individuals, respectively; 326 (34%) had less than a high school education; and 300 (31%) were in or near poverty. Median age of participants was 51 (interquartile range, 39-62) years. New-onset Medicaid home care was associated with a 0.08 standard deviation improvement in likely caregivers' self-rated mental health (95% CI, 0.01-0.14; P = .02) measured 1 to 6 months after onset, equivalent to a 3.39% improvement (95% CI, 0.05%-6.33%) over their average preonset mental health. No association with self-rated physical health was found (<0.001 standard deviations; 95% CI, −0.06 to 0.06; P = .99). CONCLUSIONS AND RELEVANCEIn this cohort study, Medicaid home care was associated with improvement in caregiver self-rated mental health, but not with any short-term change in self-rated physical health. When evaluating the social value of home care programs, policy makers should consider spillover benefits to caregivers.

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Caring for and caring about: Disentangling the caregiver effect and the family effect

Cited by 180 publications

References 46 publications

Situating Care in Mainstream Health Economics: An Ethical Dilemma?

Situating Care in Mainstream Health Economics: An Ethical Dilemma?

Caring Alone? Social Capital and the Mental Health of Caregivers

Association Between New-Onset Medicaid Home Care and Family Caregivers’ Health

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