Van Houtven CH (HSR&D)
Wilson MR (HSR&D)
Clipp EC (GRECC)
Informal care saves the VA money by substituting for VA long-term care. We examine how the intensity and type of informal care provided to veterans with progressive dementia affect caregiver drug use. If a strong association exists, informal caregivers’ drug costs should be considered when quantifying the cost savings to the VA health care system from informal care.
Survey data was collected for three years from informal caregivers (N=3,795) of a nationally representative sample of veterans diagnosed with vascular dementia or Alzheimer’s disease. Ordinary least squares regression of number of drugs taken by the caregiver on caregiver intensity was conducted. Three measures of intensity were examined—total caregiver hours, hours spent assisting with tasks of daily living, and hours spent providing companionship.
Total hours of caregiving and companionship hours are associated with small increases in the number of drugs caregivers consumed (p=.024; p=.030). Holding all else constant, a 10 percent increase in total caregiver hours is associated with a 0.4 percent increase in the number of drugs consumed. Caregivers reporting depression consumed significantly more drugs (p<.001) than the reference group. Caregivers reporting depression consumed 6.5 percent more drugs than caregivers not reporting depression.
Total caregiving time is associated with slightly higher drug consumption for caregivers of veterans with dementia. The small magnitudes indicate, however, that it may not be important to consider caregiver drug utilization costs when quantifying the net savings of informal care to the VA health care system.
The increases in caregiver drug utilization have negligible direct costs to the VA because the magnitudes are small and only a portion of caregivers is covered by VA insurance. That said, caregiver depression is associated with higher drug consumption and may impose indirect costs on the VA health care system by affecting the quality of caregiving and/or by hastening institutionalization of VA dementia patients. Efforts to ameliorate caregiver depression by screening for depression and making appropriate referrals could not only help reduce caregiver drug utilization but potentially could save the VA money by increasing the quality and duration of informal care.