The economic cost of chronic fatigue and chronic fatigue syndrome in UK primary care

McCrone, Paul; Darbishire, Lucy; Ridsdale, Leone; Seed, Paul

doi:10.1017/s0033291702006980

Cited by 88 publications

(80 citation statements)

References 21 publications

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“…Substantially higher values have been generated using opportunity cost and replacement methods, with values ranging from £3 to £14 per hour, depending on the nature of the task (Nuttall et al, 1993;Laing, 1993;Carers UK, 2002;Buckner and Yeandle, 2007;Schneider et al, 2003;Liu et al, 2002;McCrone et al, 2003). One explanation for this is that the DCE methodology allows for broader aspects of (dis)utility that individuals may derive from the provision of informal care (Van den Berg et al, 2005a).…”

Section: Discussionmentioning

confidence: 99%

“…However, given the lack of a market for such care, questions are raised concerning how such activity can be valued. A number of approaches have been employed, including opportunity cost (Schneider et al, 2003;Liu et al, 2002), market replacement cost (McCrone et al, 2003;Dewey et al, 2002), contingent valuation (CV) (Van den Berg et al, 2005;Van den Berg et al, 2005b) and conjoint analysis (Van den Berg et al, 2005a).…”

Section: Introductionmentioning

confidence: 99%

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Using discrete choice experiments to value informal care tasks: exploring preference heterogeneity

2010

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While informal care is a significant part of non-market economic activity, its value is rarely acknowledged, perhaps reflecting a lack of market data. Traditional methods to value such care include opportunity and replacement cost. This study is the first to employ the discrete choice experiment methodology to value informal care tasks. A monetary value is estimated for three tasks (personal care, supervising and household tasks). The relationship between time spent on formal and informal care is also modelled and preference heterogeneity investigated using the Latent Class Model. Complementarity between supervising tasks and formal care is observed. Monetary compensation is important, with willingness to accept per hour values ranging from £0.38 to £0.83 for personal care, £0.75 for supervising and £0.31 to £0.6 for household tasks. Heterogeneity in preferences is observed, with monetary compensation being important for younger people, but insignificant for older individuals. Such heterogeneity is important at the policy level. Values are lower than those generated by opportunity cost and replacement cost methods, perhaps because of the limited ability of revealed preference methods to capture broader aspect of utility. Differences with contingent valuation methods are also observed, suggesting future research should investigate the external validity of the different methods.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Using discrete choice experiments to value informal care tasks: exploring preference heterogeneity

2010

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“…7 Persons with CFS/ME are high users of health care services and more likely than others to be out of work. 8 The diagnosis is surrounded by controversy. 9 Most researchers now accept the view that CFS/ME is multifactorial and distinguish among factors that predispose, precipitate, and perpetuate the condition.…”

Section: Introductionmentioning

confidence: 99%

Using Multiple Sources of Knowledge to Reach Clinical Understanding of Chronic Fatigue Syndrome

Chew‐Graham

Cahill²,

Dowrick³

et al. 2008

The Annals of Family Medicine

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PURPOSE Chronic fatigue syndrome (CFS), or myalgic encephalitis (ME), is a contentious condition and often a diagnosis of exclusion. Current policy in the United Kingdom recommends management in primary care. We explored how patients with CFS/ME and family physicians understand this condition and how their understanding might affect the primary care consultation. METHODSWe undertook a qualitative study with patients and family physicians from North West England participating in a primary care-based randomized controlled trial (FINE Trial). Data were collected through purposive sampling and in-depth semistructured interviews with 24 patients and 14 family physicians. We analyzed interview transcripts using constant comparison methods. RESULTSFamily physicians access social and cultural knowledge to reach a clinical understanding of CFS/ME and its management. Patients recognize the diffi culties family physicians encounter in understanding their symptoms and access similar nonclinical sources of information. We suggest that both patients and physicians use biomedical discourse within the consultation: the physician to maintain the position as an expert, the patient to engage the physician. CONCLUSIONSFamily physicians obtain information about CFS/ME from their nonprofessional world, which they incorporate into their professional realm. Patients and physicians describe the use of the discourse of science within consultations about CFS/ME. This form of shared understanding could lead to a positive collaborative interaction. Family physicians need a biomedical, evidence-based knowledge about CFS/ME. There is potential to use the rich knowledge base that patients can bring to consultations in training initiatives directed at family physicians. Ann Fam Med 2008;6:340-348. DOI: 10.1370/afm.867. INTRODUCTIONC hronic fatigue syndrome (CFS), or myalgic encephalitis (ME), is a chronic incapacitating illness that leads to individual disability 1 and lost productivity. 2,3 The annual economic impact of chronic fatigue syndrome in the United States is estimated to be $9.1 billion in lost productivity, not including medical costs or disability payments. The average family affected by CFS/ME loses $20,000 a year in wages and earnings.1 Patients usually experience multiple additional symptoms, 4 commonly with comorbid psychiatric disorders. 5 Prognosis is poor 6 and is accompanied by functional impairment and reduced quality of life. 7 Persons with CFS/ME are high users of health care services and more likely than others to be out of work. 8 The diagnosis is surrounded by controversy. 9 Most researchers now accept the view that CFS/ME is multifactorial and distinguish among factors that predispose, precipitate, and perpetuate the condition. In 2002 the UK Department of Health recommended that CFS/ME should be managed wherever possible in the community by family physicians supported by local multidisciplinary teams. 11 In the absence of a fi rm evidence base for treatment of CFS/ME in primary care, this recommendation was ...

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Section: Introductionmentioning

confidence: 99%

“…CFS is associated with a high use of health care services and, hence, with high societal costs [2][3][4][5][6]. It has been found that 39% of the CFS population in the UK uses at least one type of prescribed medication and 71% of them receive informal home care [2]. Jones et al [5] found that, compared to nonfatigued controls, more CFS patients reported to using any kind of (un)prescribed medication (92% vs. 82%, Pb.00) and to using more different types of medication (5 vs. 2, Pb.00).…”

Section: Introductionmentioning

confidence: 99%

Determinants of health care use in chronic fatigue syndrome patients: A cross-sectional study

Scheeres

Wensing

Severens

et al. 2008

Journal of Psychosomatic Research

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The economic cost of chronic fatigue and chronic fatigue syndrome in UK primary care

Abstract: Chronic fatigue imposes substantial economic costs on society, mainly in the form of informal care and lost employment. Treatments need to be developed which recognize these impacts.

Cited by 88 publications

References 21 publications

Using discrete choice experiments to value informal care tasks: exploring preference heterogeneity

Using discrete choice experiments to value informal care tasks: exploring preference heterogeneity

Using Multiple Sources of Knowledge to Reach Clinical Understanding of Chronic Fatigue Syndrome

Determinants of health care use in chronic fatigue syndrome patients: A cross-sectional study

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