Researchers recommend ways to measure ‘spillover effects’ on families, caregivers

Imagine the unthinkable: A child diagnosed with cancer who suddenly needs extensive treatment and care for a lengthy period. Researchers have long studied the economic value of that care (e.g., outcomes relative to cost) but measuring the impact of patient illness on parents or caregivers has been underestimated and inconsistently incorporated into economic evaluations.

A new paper published in the Journal of Applied Health Economics and Health Policy led by Ashley Leech, Ph.D., Assistant Professor of Health Policy, and colleagues recommends a way researchers can better measure “family spillover effects”, i.e., how illness extends beyond the patient to unpaid caregivers and other family members.

a photo of ashley leech, phd

The paper recommends incorporating these impacts into health economic evaluations to represent the economic value of healthcare interventions more accurately to society.

“While the consequences of illness on family members have been well documented, they are rarely incorporated into health economic evaluations, even among diseases with high family involvement,” Leech said. “We may therefore be misrepresenting an intervention’s true value when excluding these effects.”

To date, researchers have most often estimated family/caregiver impact in terms of lost productivity, frequently described as time away from work, but does not account for other impacts like mental health effects of caregiving, travel time and expenses, or other areas that impact their quality of life.

To address this, Leech recommends integrating data from clinical trials, patient registries, “expert opinion” and mapping algorithms to better assess the true impact that patient illness may have on family members.

“Excluding family spillover costs and health-related quality of life consequences from economic evaluations assumes the estimates are zero. In the absence of data in the short term, involving experts to estimate or recommend proxy values might be more accurate than excluding these effects altogether,” Leech said.