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Refereed Publications

  1. Van Houtven, C. H. and Thorpe, J. M. and Chestnutt, D. and Molloy, M. and Boling, J. C. and Davis, L. L., Do nurse-led skill training interventions affect informal caregivers' out-of-pocket expenditures?, The Gerontologist, vol. 53 no. 1 (February, 2013), pp. 60-70, ISSN 1758-5341 [doi]
    (last updated on 2013/09/06)

    Purpose of the Study: This paper is a report of a study of the Assistance, Support, and Self-health Initiated through Skill Training (ASSIST) randomized control trial. The aim of this paper is to understand whether participating in ASSIST significantly changed the out-of-pocket (OOP) costs for family caregivers of Alzheimer's disease (AD) or Parkinson's disease (PD) patients. DESIGN AND METHODS: Secondary analysis of randomized control trial data, calculating average treatment effects of the intervention on OOP costs. Enrollment in the ASSIST trial occurred between 2002 and 2007 at 2 sites: Durham, North Carolina, and Birmingham, Alabama. We profile OOP costs for caregivers who participated in the ASSIST study and use 2-part expenditure models to examine the average treatment effect of the intervention on caregiver OOP expenditures. RESULTS: ASSIST-trained AD and PD caregivers reported monthly OOP expenditures that averaged $500-$600. The intervention increased the likelihood of caregivers spending any money OOP by 26 percentage points over usual care, but the intervention did not significantly increase overall OOP costs. IMPLICATIONS: The ASSIST intervention was effective and inexpensive to the caregiver in direct monetary outlays; thus, there are minimal unintended consequences of the trial on caregiver financial well-being.

    Adaptation, Psychological • Aged • Aged, 80 and over • Alzheimer Disease • Caregivers • Cost of Illness* • Costs and Cost Analysis • Health Education • Health Expenditures* • Humans • Insurance, Health • Intervention Studies • Long-Term Care • Male • Middle Aged • Multivariate Analysis • Parkinson Disease • Social Support • Socioeconomic Factors • economics • economics* • education* • nursing • psychology