Scottish Government Health Directorates Chief Scientist Office
FEASIBILITY STUDY OF USE OF DIRECT PAYMENTS FOR INFORMAL CARE Researchers Professor A Ludbrook, Dr P McNamee, Dr Y Feng
but may be subject to biased responses related to non-anonymity.
The overall goal of this feasibility study was to use a structured questionnaire survey of households, with at least one individual aged 65 years or over, carers or potential carers, to identify preferences for and responses to alternative payment systems for informal care.
Within the sample who did respond to the surveys, there appears to be reasonable support for payments for unpaid care, but such a scheme would appear to be likely to lead to only small changes in the type or level of support provided, with only 5/18 respondents indicating that care arrangements would be likely change as a result of payments.
Project Outline/Methodology
What does this study add to the field?
A structured questionnaire survey of households was planned. Questionnaire content was informed by a literature review of relevant studies, together with development of question wording from similar household surveys (British Household Panel Survey and Scottish Household Survey). Two pilot surveys were undertaken refine the questionnaire and test the response rate. Both surveys achieved very poor response rates. An alternative strategy involving a very short questionnaire to carers on a voluntary agency data base also had a low response.
This feasibility study has highlighted the difficulties of identifying a relevant sample for research in this area and obtaining responses using postal survey methods. Previous research on the same group had suggested much better response rates were achievable.
Aim
Implications for Practice or Policy Direct payment systems remain an important area of policy interest. Should there be a policy change in this area, careful consideration needs to be given to methods used in any policy evaluation.
Key Results A majority (6/8) of care users would not use any new payment system to change the amount of help currently received, or would not use any new system to pay relatives, friends or neighbours for care should they require it in the future. However, 4/8 did consider the idea of such a system acceptable. Amongst care providers, 6/10 respondents found the idea of payment for unpaid carers acceptable, although only 3/10 indicated that such a system would induce them to provide more care.
Conclusions It does not appear feasible to explore attitudes towards payment for help with household tasks and personal care, and potential changes in levels of unpaid care that might arise from such payment, with postal surveys of older people living in sheltered housing, or with adult carers who are known to voluntary agencies such as Carer Centres. Other methods that rely on some form of face to face administration may yield a greater level of response,
Where to next? This study would suggest that policy evaluation concerned with examining the consequences of changes to payment systems for unpaid carers should use some form of in-person survey administration rather than postal surveys of community households, or alternatively, should draw on existing secondary data such as the Scottish Household Survey.
Further details from: Dr P McNamee Health Economics Research Unit University of Aberdeen Foresterhill ABERDEEN AB25 2ZD
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