Open Access Open Badges Research article

Economic valuation of informal care in cerebrovascular accident survivors in Spain

Juan Oliva-Moreno12*, Isaac Aranda-Reneo3, Cristina Vilaplana-Prieto4, Almudena González-Domínguez5 and Álvaro Hidalgo-Vega1

Author Affiliations

1 Department of Economic and Financial Analysis, Faculty of Legal and Social Sciences, University of Castilla-La Mancha, Toledo, Spain

2 Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Toledo, Spain

3 Department of Economic and Financial Analysis, Facultad de Ciencias Jurídicas y Sociales, Universidad de Castilla-La Mancha, Cobertizo San Pedro, Mártir, Toledo s/n 45071, Spain

4 University of Murcia, Murcia, Spain

5 Biostatistics Department, Max Weber Institute, Majadahoda, (Madrid), Spain

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BMC Health Services Research 2013, 13:508  doi:10.1186/1472-6963-13-508

Published: 5 December 2013



Cerebrovascular diseases are the second leading cause of death worldwide and one of the health conditions which demand the highest level of social services. The aim of this study was to estimate the social cost of non-professional (informal) care provided to survivors of cerebrovascular accidents (CVA) with some type of disability in Spain.


We obtained data from the 2008 Survey on Disability, Independent Living and Dependency (EDAD-08) on the main characteristics of individuals who provide informal care to survivors of CVAs in Spain. We estimated the cost of substituting informal care in favor of formal care provided by professional caregivers (proxy good method) and performed a statistical analysis of the relationship between degree of dependency and number of care hours provided using ordinary least squares regression.


The number of disabled people diagnosed with CVA totaled 1,975 (329,544 people when extrapolating to the national population using the elevation factor provided by EDAD-08). Of these, 1,221 individuals (192,611 people extrapolated to the national population) received at least one hour of informal care per week. The estimated hours of informal care provided in 2008 amounted to 852 million. The economic valuation of the time of informal care ranges from 6.53 billion euros (at 7.67 euros/hour) to 10.83 billion euros (when calculating each hour of care at 12.71 euros). The results of our statistical analysis highlight the importance of degree of dependency in explaining differences in the number of hours of informal care provided.


The results of our study reveal the high social cost of cerebrovascular accidents in Spain. In addition, evidence is presented of a correlation between higher degree of dependency in CVA survivors and greater number of hours of care received. An integral approach to care for CVA survivors requires that the caregivers’ role and needs be taken into account.