The time cost of care

Bittman, Michael; Fisher, Kimberly; Hill, Patricia Evridge; Thomson, Cathy

doi:10.13085/eijtur.2.1.54-66

Cited by 26 publications

(32 citation statements)

References 5 publications

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“…Bittman & Thomson [11] and Bittman et al [12,13] found the ABS’ Disability , Ageing and Carers Survey (2003) and Time Use Survey (1998) contained limited and problematic information about the time devoted to care. The broad ABS categories include meal preparation, property maintenance, housework, transport, paperwork, health care, cognition or emotion, communication, and mobility, but the data provide no details of what some of these may involve, nor how much time is spent for each except with cross tabulations with other variables such as carer’s and care recipient’s age group, disability level (which may or may not include a chronic illness), or years of care provided, at best revealing an average weekly range of 6 to 27 hours, climbing to over 105 hours depending on the severity of disability.…”

Section: Resultsmentioning

confidence: 99%

“…“Consequently, there is hardly any systematic knowledge about what determines the quantity of labour required for informal care, its nature or its intensity and the demands it places on families. Therefore it is not possible to estimate the demands placed on carers, how they vary according to changes in circumstances and to make informed judgements about the supply of caring labour” [13]: 57.…”

Section: Resultsmentioning

confidence: 99%

“…Bittman et al [13] examined two data sets on time use from the Australian Bureau of Statistics that utilized two different methods (the 1998 Australian Survey of Disability , Ageing and Carers , which included time use estimates based on a question concerning hours spent weekly on activities, and diary estimates from the 1997 national Australian Time Use Survey ). They argue there is an inconsistency in the two estimates, and this may be because of methodological reasons such as; "the time use data may well miss out some supervisory time, and not always indicate the extent to which carers rearrange their schedules to be nearby to the care recipient in case they are needed" [13]: 62. Regardless of which mode of time measurement is utilised by a study there are likely to be aspects of time use which, for whatever reason, are not captured.…”

Section: Discussionmentioning

confidence: 99%

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Time spent on health related activities associated with chronic illness: a scoping literature review

Jowsey

Yen

2012

BMC Public Health

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BackgroundThe management of health care, particularly for people with chronic conditions, combines the activities of health professionals, patients, informal carers and social networks that support them. Understanding the non-professional roles in health management requires information about the health related activities (HRA) that are undertaken by patients and informal carers. This understanding allows management planning that incorporates the capacity of patients and informal carers, as well as identifying the particular skills, knowledge and technical support that are necessary. This review was undertaken to identify how much time people with chronic illness and their informal carers spend on HRA.MethodsLiterature searches of three electronic databases (CINAHL, Medline, and PubMed) and two journals (Time and Society, Sociology of Health and Illness) were carried out in 2011 using the following search terms (and derivatives): chronic illness AND time AND consumer OR carer. The search was aimed at finding studies of time spent on HRA. A scoping literature review method was utilised.ResultsTwenty-two peer reviewed articles published between 1990 and 2010 were included for review. The review identified limited but specific studies about time use by people with a chronic illness and/or their carers. While illness work was seen as demanding, few studies combined inquiry about both defined tasks and defined time use. It also identified methodological issues such as consistency of definition and data collection methods, which remain unresolved.ConclusionsWhile HRA are seen as demanding by people doing them, few studies have measured actual time taken to carry out a comprehensive range of HRA. The results of this review suggest that both patients with chronic illness and informal carers may be spending 2 hours a day or more on HRA. Illnesses such as diabetes may be associated with higher time use. More empirical research is needed to understand the time demands of self-management, particularly for those affected by chronic illness.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Time spent on health related activities associated with chronic illness: a scoping literature review

Jowsey

Yen

2012

BMC Public Health

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“…Recall questionnaires were used in this study rather than diaries to limit the burden of the research on the respondents and to encourage response [32], [33], [34]. Time use was defined as the time reportedly spent on any activity in three groups of health-related activities:…”

Section: Methodsmentioning

confidence: 99%

Time’s Up. Descriptive Epidemiology of Multi-Morbidity and Time Spent on Health Related Activity by Older Australians: A Time Use Survey

et al. 2013

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Most Western health systems remain single illness orientated despite the growing prevalence of multi-morbidity. Identifying how much time people with multiple chronic conditions spend managing their health will help policy makers and health service providers make decisions about areas of patient need for support. This article presents findings from an Australian study concerning the time spent on health related activity by older adults (aged 50 years and over), most of whom had multiple chronic conditions. A recall questionnaire was developed, piloted, and adjusted. Sampling was undertaken through three bodies; the Lung Foundation Australia (COPD sub-sample), National Diabetes Services Scheme (Diabetes sub-sample) and National Seniors Australia (Seniors sub-sample). Questionnaires were mailed out during 2011 to 10,600 older adults living in Australia. 2540 survey responses were received and analysed. Descriptive analyses were completed to obtain median values for the hours spent on each activity per month. The mean number of chronic conditions was 3.7 in the COPD sub-sample, 3.4 in the Diabetes sub-sample and 2.0 in the NSA sub-sample. The study identified a clear trend of increased time use associated with increased number of chronic conditions. Median monthly time use was 5–16 hours per month overall for our three sub-samples. For respondents in the top decile with five or more chronic conditions the median time use was equivalent to two to three hours per day, and if exercise is included in the calculations, respondents spent from between five and eight hours per day: an amount similar to full-time work. Multi-morbidity imposes considerable time burdens on patients. Ageing is associated with increasing rates of multi-morbidity. Many older adults are facing high demands on their time to manage their health in the face of decreasing energy and mobility. Their time use must be considered in health service delivery and health system reform.

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“…For example, Bittman and Thomson’s [22] Australian study of informal carer time use (which includes chronic illness care as well as parent care of children with mental and physical impairments), reported that an average of around five hours per week was spent in care-related activities. A subsequent study, which adjusted the estimates from the 1997 Australian Time Use Survey, found that the median time spent by informal carers is around an hour and a half per day (or 10.5 hours per week) [23]. Bittman and colleagues also reported that carers of people with a functional impairment (including but not limited to impairments related to chronic illness) spend considerably more time engaging in cooking and cleaning activities than non-carers [24].…”

Section: Introductionmentioning

confidence: 99%

Time to care? Health of informal older carers and time spent on health related activities: an Australian survey

et al. 2013

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BackgroundLittle is known about the time spent on specific health related activities by older adult informal carers who assist people with chronic illness. Research has not yet addressed the association between carer health status and their care demands. Such information could inform policy and health system efforts to manage chronic illness.MethodsWe conducted an Australia wide survey using recall questionnaires to record time use. The study asked how much time is spent on “most days” for the most common activities like taking medication, self-treatment and testing, and how much time in the last month on less common activities like attending a physician or shopping associated with health needs. The survey was mailed to 5,000 members of National Seniors Australia; 2,500 registrants on the National Diabetes Services Scheme; and 3,100 members of the Australian Lung Foundation. A total of 2519 people responded, including 313 people who identified as informal carers. Statistical analysis was undertaken using Stata 11. Standard errors and confidence intervals were derived using bootstrapping techniques within Stata 11.ResultsMost carers (96.2%) had chronic illness themselves, and those with greater numbers of chronic illnesses were those who faced the greatest overall time demands. The top decile of carers devoted between 8.5 and 10 hours a day to personal and caring health related activities. Informal carers with chronic illness spent more time managing their own health than people with chronic illness who were not informal carers. These carers spent more time on caring for others than on caring for their own health. High levels of caring responsibility were associated with poorer reported carer health.ConclusionsPolicy and health care services will need to adapt to recognise and reduce the time burden on carers who themselves have chronic illness. More carefully targeted investment in the social infrastructure of formal care would free up carers for other activities (including their own care) and holds the potential to improve the quality of life as well as the health outcomes of this population.

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The time cost of care

Cited by 26 publications

References 5 publications

Time spent on health related activities associated with chronic illness: a scoping literature review

Time spent on health related activities associated with chronic illness: a scoping literature review

Time’s Up. Descriptive Epidemiology of Multi-Morbidity and Time Spent on Health Related Activity by Older Australians: A Time Use Survey

Time to care? Health of informal older carers and time spent on health related activities: an Australian survey

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