Informal Caregiving in Australian Veteran Families: Economic Costs, Caregiver Burden, and Health-Related Quality of Life Spillover Effects

Introduction Military service can have substantial spillover effects on family well-being, particularly in households where informal caregiving is required for injured or ill veterans. Despite increasing recognition of the importance of incorporating caregiver and family outcomes into economic and health service evaluations, there is limited empirical evidence quantifying the economic value and impacts of informal caregiving among Australian veteran families. This study aimed to estimate the economic value of caregiving and examine the impact of informal caregiving for injured or ill veterans on caregiver burden and health-related quality of life (HRQoL) in Australian veteran families. Materials and Methods In a national cross-sectional survey, 245 adult veteran caregivers reported demographics, caregiving intensity and burden (Self-Reported Burden Scale [SRB]), HRQoL (Assessment of Quality of Life 8 Dimension [AQoL-8D]), and care recipient health (EQ-5D-5L). Costs of informal care were estimated using the replacement cost method, with varying wage-rate loadings and intensive caregiving thresholds tested for robustness. HRQoL spillovers were assessed as relative (associations between caregiver and care recipient HRQoL using regression) and absolute (differences between veteran caregivers and matched general population caregivers from the Household, Income, and Labour Dynamics in Australia Survey). Sensitivity analyses using different matching techniques tested the robustness of absolute spillover estimates. Results Caregivers provided a median of 30 hours/week, with a median caregiving duration of 10 years; nearly half reported needing additional support. The caregiver perceived burden was moderate (mean SRB score 5.7). Median weekly replacement costs were AU$1,052, translating to a median total cost of AU$544,895 per caregiver over their respective caregiving durations. Caregiver HRQoL was positively associated with care recipient HRQoL, caregiver age, and caregiver postgraduate education, and negatively associated with caregiver perceived burden and caregiver number of chronic conditions. Compared with general caregivers, veteran caregivers experienced significant HRQoL losses (0.135 QALYs/year; 95% CI: −0.17 to −0.10). Findings were robust in sensitivity analyses. Conclusion Informal caregiving for injured or ill veterans is associated with substantial economic, caregiving, and HRQoL burdens on family caregivers. Incorporating caregiver outcomes into economic evaluations, service planning, and policy is essential for a more accurate estimate of intervention value and better inform resource allocation decisions across Defence, Veterans’ Affairs, and national disability and mental health systems.