Putting a dollar value on informal care time provided to people living with dementia: a discrete choice experiment

Objectives Informal care represents a significant cost driver in dementia but monetising informal care hours to inform cost-of-illness or economic evaluation studies remains a challenge. This study aimed to use a discrete choice experiment (DCE) to estimate the value of informal care time provided to people with dementia in Australia accounting for positive and negative impacts of caregiving. Methods Attributes and levels were derived from a literature review, interviews with carers and advice received from an advisory group. Attributes included four positive and negative caregiving experiences, in addition to 'hours of care provided' and the 'monetary compensation from the government'. A D-efficient design was constructed with two generic alternatives that represented hypothetical informal caregiving situations. The DCE survey was administered online to a representative sample of the Australian general population and a group of informal carers of people with dementia. The willingness to accept (WTA) estimates were calculated for the two samples separately using the mixed logit model in the willingness to pay space. Results Based on 700 respondents included in the analysis (n=488 general public, n=212 informal carers), the mean WTA for an additional hour of informal care, corrected for the positive and negative impacts of informal care, was $21 (95% CI: 18-23) for the general public and $20 (95% CI: 16-25) for the informal carers sample. Conclusion The estimates generated in this study can be used to inform future cost-of-illness studies and economic evaluations, ensuring that informal care time is considered in future policy and funding decisions.