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Dementia Family Caregivers’ Willingness to Pay for an In-home Program to Reduce Behavioral Symptoms and Caregiver Stress

  • Eric JutkowitzEmail author
  • Danny Scerpella
  • Laura T. Pizzi
  • Katherine Marx
  • Quincy Samus
  • Catherine Verrier Piersol
  • Laura N. Gitlin
Original Research Article

Abstract

Objectives

Our objective was to determine whether family caregivers of people with dementia (PwD) are willing to pay for an in-home intervention that provides strategies to manage behavioral symptoms and caregiver stress and to identify predictors of willingness-to-pay (WTP).

Methods

During baseline interviews of a randomized trial and before treatment assignment, caregivers were asked how much they were willing to pay per session for an eight-session program over 3 months. We stratified the sample into those who refused to provide a WTP, those willing to pay $US0, and those willing to pay > $US0. We used a two-part model, controlling for demographic characteristics, to predict adjusted mean WTP and to examine associations between WTP, clinical features (cognition, function, behavioral symptoms), and time spent assisting PwD with daily activities. First, we used logistic regression to model the probability a caregiver was willing to pay > $US0. Second, we used a generalized linear model (log link and Gamma distribution) to estimate the amount caregivers were willing to pay conditional on WTP > $US0.

Results

Of 250 dyads enrolled, 226 (90%) had complete data and were included in our analyses. Of 226 dyads, 26 (11%) refused to provide a WTP value, 72 (32%) were willing to pay $US0, and 128 (57%) were willing to pay > $US0. In the combined model, mean adjusted WTP was $US36.00 (95% confidence interval [CI] 26.72–45.27) per session. Clinical features were not significantly associated with WTP. One additional hour providing PwD assistance was associated with a $US1.64 (95% CI 0.23–3.04) increase in WTP per session.

Conclusion

As caregivers spend more time assisting with daily activities, they are willing to pay more for a supportive program.

Clinical Trial Registration Number

NCT01892579.

Notes

Author Contributions

EJ, LTP, KM, LNG: study design and analysis. All authors participated in the interpretation of data, drafting of manuscript, critical revision of manuscript, and approval of final manuscript.

Compliance with Ethical Standards

Data Availability

This dataset is available upon request from the senior author (Dr. Laura N. Gitlin).

Funding

This study was supported by a grant from the National Institute on Aging (Grant #R01 AG041781-01A1).

Conflicts of interest

EJ, DS, LTP, KM, QS, CVP, and LNG have no conflicts of interest that are directly relevant to the content of this article. LNG is an inventor of a training program for the TAP intervention for which Johns Hopkins University is entitled to fees. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies.

Supplementary material

40273_2019_785_MOESM1_ESM.docx (117 kb)
Supplementary material 1 (DOCX 117 kb)

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Eric Jutkowitz
    • 1
    Email author
  • Danny Scerpella
    • 2
  • Laura T. Pizzi
    • 3
  • Katherine Marx
    • 4
  • Quincy Samus
    • 4
  • Catherine Verrier Piersol
    • 5
  • Laura N. Gitlin
    • 2
    • 6
  1. 1.Department of Health Services, Policy and PracticeBrown University School of Public HealthProvidenceUSA
  2. 2.Johns Hopkins University Center for Innovative Care in AgingBaltimoreUSA
  3. 3.Center for Health Outcomes, Policy, and EconomicsRutgers University Ernest Mario School of PharmacyPiscatawayUSA
  4. 4.Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreUSA
  5. 5.Department of Occupational TherapyThomas Jefferson UniversityPhiladelphiaUSA
  6. 6.College of Nursing and Health ProfessionsDrexel UniversityPhiladelphiaUSA

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