Informal end-of-life care-hidden costs: multi-method analysis.

OBJECTIVE

To estimate the economic costs of informal caregiving at the end of life in Argentina, incorporating both direct and indirect costs, and to analyse their distribution through a gender equity lens.

METHODS

The study is part of the international iLIVE project and includes data from 153 informal caregivers of patients with life-limiting illnesses in Argentina. Costs were estimated using both the opportunity cost and proxy-good methods. Information was collected at baseline and at the 30-day follow-up using the Caregiver Impact Questionnaire, which measured the time spent on caregiving activities, work productivity losses and compensation. Gender-disaggregated analyses were conducted.

RESULTS

Caregivers provided an average of 57 hours of informal care per week and lost 25 hours of paid work. Emotional support represented the largest share of time (36%), followed by household tasks (25%), practical assistance (22%) and personal care (17%). Using the opportunity cost method, societal costs averaged US$29 293 at baseline and US$18 851 at follow-up. The estimated annual costs using the proxy-good method were US$32 065 at baseline and US$21 595 at follow-up. Women consistently incurred higher costs than men, with a female-to-male cost ratio of 2.0 for unpaid care. Nearly all caregivers (98%) received no financial compensation.

CONCLUSION

Informal caregiving at the end of life entails a considerable and often overlooked economic burden in Argentina, disproportionately affecting women. Recognising and valuing this work in economic evaluations and public policy is essential to promote gender equity and build more sustainable health systems.