Estimating the economic burden of stroke among informal caregivers in Australia using Productivity Adjusted Life Year

Abstract

Background: The Productivity Adjusted Life Year (PALY) metric is a novel measure for exploring the societal impact of health conditions on work productivity. Given that stroke is a major cause of DALYs (disability-adjusted life years) and the crucial role of caregivers in post-stroke care our study aims to quantify the PALY loss associated with stroke caregivers and the impact on their quality of life (QoL) by calculating quality-adjusted life years (QALYs). Method: Dynamic life table modeling was used to simulate the follow-up of the Australian working-age population (aged 15-65 years) over 30 years of follow-up (2023-2052 inclusive). The model compared the Australian stroke informal carer group and a hypothetical cohort of non-carers. Key data was obtained from literature and publicly available data. The model was constructed using Microsoft Excel® (Microsoft Corporation, Redmond, WA, US). Labor force participation rates were applied to population estimates to arrive at the approximate number of full-time equivalent (FTE) which was then multiplied by the productivity index and years of life lived (YLL) to estimate PALYs and the utility values were multiplied by YLL to estimate QALYs. Results: Over a 30-year period, an estimated 35,337 QALYs and 87,773 PALYs and AU$ 19.1 billion were lost due to the health and productivity burden attributed to the provision of informal care for stroke patients. On average, annual informal carer losses were 1,178 QALYs and 2,926 PALYS, corresponding to AU$ 636 million per year in productivity loss. Conclusion: Our analyses demonstrate the health and economic consequences of providing care to stroke patients over the forthcoming decades and highlight the need for interventions to reduce the burden of stroke and its impact on caregivers.