Informal caregiving and time allocation decisions among caregivers to the severely mentally ill

摘要

This study explored the time allocation decisions of families coresiding with chronically ill relatives who have functional limitations with which human assistance is needed. The major purpose of this study was to examine the factors that determine an adult family member's caregiving role and employment status, and to discern any differences between households caring for mentally ill family members and households caring for family members with other illnesses. This study estimated the probability of being employed part-time, full-time or not at all, and the probability of being the primary caregiver, secondary caregiver or noncaregiver. A second purpose of this study was to analyze variables of policy interest. The study examined the effect on family caregiving and employment of public policies that may act as potential substitutes for family caregiving, such as Medicaid coverage of personal care and home care services. It also examined the relationship between changing labor market conditions and family caregiving and employment.;The study was cross-sectional. Adult family members coresiding with a care recipient were the units of analysis. Household and individual-level data were from the 1990 through 1993 Surveys of Income and Program Participation (SIPP). State-level labor market data were obtained from relevant years of the Current Population Survey (CPS). Labor supply and caregiving equations were estimated using ordered probit models.;The eight hypotheses tested involved the effects on caregiving role and employment status of the following: (1) the adult family member's wage rate, (2) the average wage rate of potential caregivers who coreside in the household, (3) the price of market-purchased care, (4) the technology of informal care production, (5) the technology of household production, (6) household property income, (7) individual tastes and preferences, and (8) labor market conditions.;The results of ordered probit estimation of the employment and caregiving equations suggested that the factors related to employment and caregiving include the adult family member's wage rate, the technology of informal care production, the technology of household production, individual tastes and preferences, and labor market conditions.;A potential problem of this study was sample self-selectivity due to living arrangement choice. Because no data were available for potential coresidents when separate living arrangements were chosen, a coresidence selection equation could not be estimated, nor could a formal test for omitted variable bias be conducted. In the absence of a selection equation, the approach taken was to add to the model two "selection" variables, one representing the quantity and quality of coresidential programs for the severely mentally ill, and the other the number of beds in certified nursing facilities. The stability of the policy variables (Medicaid personal care services and home health services) in the presence and absence of these "selection" variables was analyzed as an informal test of selection bias.