Projects per year
Abstract
Objectives
Impacts on informal carers are increasingly being incorporated into cost-of-illness and cost-effectiveness analyses. However, little is known about whether the method used to identify carers affects the estimated impacts. We compare a novel time diary technique to a common self-declaration question for identifying carers. We investigate whether it: (i) detects more and different carers and (ii) if carers across identification techniques have different mental health outcomes.
Methods
We use the Innovation Panel component of the UK Household Longitudinal Study, which records all activities performed in two 24-hour periods and contains a rich set of individual characteristics. We use regression analysis to compare the number and characteristics of carers identified across the two methods. We then use the doubly-robust approach of entropy balancing combined with regression adjustment to estimate the mental health impacts of caregiving across both methods.
Results
Among 1055 individuals, we identify 261 carers by at least one method. The self-declaration method fails to classify 16% of individuals identified as carers through time diary data. We find that carers identified by the time diary have a 1.24 (p<0.05) higher score on the 36-point GHQ scale in the subsequent survey wave compared to similar non-carers. For self-declared carers, the estimated difference in GHQ score is 0.36 (p>0.1), a smaller and statistically non-significant association compared to that observed among time diary-identified carers.
Conclusion
The mental health impacts of caregiving may be under-estimated when carers are identified by self-declaration. Supplementing self-declaration with time diaries may offer a means of including more carers. Future research, if only one method is applied, should more carefully consider the means of identifying informal carers and the implications that the use of one method may have on conclusions.
Impacts on informal carers are increasingly being incorporated into cost-of-illness and cost-effectiveness analyses. However, little is known about whether the method used to identify carers affects the estimated impacts. We compare a novel time diary technique to a common self-declaration question for identifying carers. We investigate whether it: (i) detects more and different carers and (ii) if carers across identification techniques have different mental health outcomes.
Methods
We use the Innovation Panel component of the UK Household Longitudinal Study, which records all activities performed in two 24-hour periods and contains a rich set of individual characteristics. We use regression analysis to compare the number and characteristics of carers identified across the two methods. We then use the doubly-robust approach of entropy balancing combined with regression adjustment to estimate the mental health impacts of caregiving across both methods.
Results
Among 1055 individuals, we identify 261 carers by at least one method. The self-declaration method fails to classify 16% of individuals identified as carers through time diary data. We find that carers identified by the time diary have a 1.24 (p<0.05) higher score on the 36-point GHQ scale in the subsequent survey wave compared to similar non-carers. For self-declared carers, the estimated difference in GHQ score is 0.36 (p>0.1), a smaller and statistically non-significant association compared to that observed among time diary-identified carers.
Conclusion
The mental health impacts of caregiving may be under-estimated when carers are identified by self-declaration. Supplementing self-declaration with time diaries may offer a means of including more carers. Future research, if only one method is applied, should more carefully consider the means of identifying informal carers and the implications that the use of one method may have on conclusions.
| Original language | English |
|---|---|
| Journal | PharmacoEconomics |
| DOIs | |
| Publication status | Published - 16 May 2025 |
Keywords
- Informal care
- time diary
- measurement
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Dive into the research topics of 'Does the informal carer identification method matter? Evidence from self-declaration and time diary approaches'. Together they form a unique fingerprint.Projects
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NIHR Applied Research Collaboration Greater Manchester.
Cullum, N. (PI), Abel, K. (CoI), Ainsworth, J. (CoI), Arden Armitage, C. (CoI), Bee, P. (CoI), Bower, P. (CoI), Bucci, S. (CoI), Burden, S. (CoI), Burns, A. (CoI), Checkland, K. (CoI), Dixon, W. (CoI), Dowding, D. (CoI), Dumville, J. (CoI), French, D. (CoI), Grande, G. (CoI), Green, J. (CoI), Griffiths, J. (CoI), Hodgson, D. (CoI), Keady, J. (CoI), Kislov, R. (CoI), Kontopantelis, E. (CoI), Lovell, K. (CoI), Meacock, R. (CoI), Morciano, M. (CoI), Munford, L. (CoI), O'Neill, T. (CoI), Peek, N. (CoI), Pendleton, N. (CoI), Sanders, C. (CoI), Spooner, S. (CoI), Stanmore, E. (CoI), Sutton, M. (CoI), Todd, C. (CoI), Turner, S. (CoI), Van Der Veer, S. (CoI), Webb, R. (CoI), Whittaker, W. (CoI) & Wilson, P. (CoI)
1/10/19 → 30/09/24
Project: Research