Data Sheet 3_What is the care economy? A scoping review on current evidence, challenges, facilitators and future opportunities.xlsx

BackgroundThe care economy gained its prominence during the COVID-19 pandemic. The value and impact of caregiving, mostly shouldered by women, was not as visible until such crisis point. Health care and social support sectors represent the largest and fastest growing industry globally. This scoping review aims to elucidate the current state of play in the care economy, where there is a great reliance on informal and formal care workforce to deliver care for populations across all age groups and abilities.
MethodsFollowing Joanna Briggs Institute (JBI) methodology and PRISMA-SCR reporting guidance, we searched MEDLINE, Embase, CINAHL, PsycINFO, Campbell collaboration database, Social Science Abstracts, Library and Information Science Abstracts (LISA) and Scopus. Quantitative and qualitative original research on disability, aged care, early childhood education and care, rural, veterans, migrants and informal and formal care workforce from January 2018 until November 2023 were examined.
ResultsOf 354 studies selected, 20% were from the United States of America, 11% each were from China and the United Kingdom. Most studies employed cross-sectional design. A quarter of the studies included adults aged 65 years and above while 6% were adults aged 18 to 64 years. These age groups combined were included in an additional 27% of studies. Women were overrepresented in 70% of the studies. Nearly two-thirds of caregivers were spouses or partners. Barriers to providing care were lack of education, support and monitoring of caregiver well-being, loss of income or ability to earn money, reduced social life and increased out-of-pocket costs. Gaps in research included migrant populations’ contribution to the care economy, gender and diversity inequality in the care economy. The care economy could be improved through providing education for caregivers, care workforce engaging with caregivers in the care plan, and governments’ overhaul of compensation for caregivers through direct financial support and employment benefits.
ConclusionThe care economy is an emerging research area. There continues to be a paucity of research evidence across some geographical areas. Studies are mostly short term or small scale with very little evidence around the value of care. Given the growing aging population, more research is needed to elucidate the positive aspects of caring by formal and informal care workforce to the population, society and economy.
Protocol registrationThe protocol is registered with Open Science Framework (10.17605). “Definitions, key themes and aspects of the care economy-a scoping review protocol,” https://osf.io/ypmuh.

**背景** 护理经济（care economy）在新型冠状病毒肺炎（COVID-19）大流行期间受到广泛关注。此前，绝大多数由女性承担的照护工作的价值与影响并未得到充分彰显，直至此次公共卫生危机才得以显现。医疗保健与社会支持行业是全球规模最大且增长最快的产业。本范围综述旨在阐明护理经济领域的当前研究现状：当前护理服务高度依赖非正式与正式护理人员，为各年龄段、各能力水平的人群提供照护支持。

**方法** 本研究遵循乔安娜·布里格斯研究所（Joanna Briggs Institute, JBI）方法学框架与PRISMA-SCR报告规范，对MEDLINE、Embase、CINAHL、PsycINFO、坎贝尔协作网数据库、社会科学文摘、图书馆与信息科学文摘（LISA）及Scopus数据库进行了检索。检索时限为2018年1月至2023年11月，纳入研究类型为针对残疾人群、老年照护、幼儿教育与照护、农村地区、退伍军人、移民群体以及非正式与正式护理人员的定量与定性原创研究。

**结果** 最终纳入354项研究，其中20%来自美国，中国与英国各占11%。多数研究采用横断面研究设计。四分之一的研究纳入了65岁及以上成年人，6%的研究纳入了18~64岁成年人，另有27%的研究同时涵盖了这两个年龄群体。70%的研究中女性占比偏高。近三分之二的照护者为配偶或伴侣。照护工作面临的障碍包括：缺乏针对照护者的教育支持与健康监测、收入损失或创收能力下降、社交生活减少以及自付费用增加。当前研究存在的空白包括：移民群体对护理经济的贡献、护理经济中的性别与多元不平等问题。可通过以下路径优化护理经济：为照护者提供教育培训、护理人员与照护者共同制定照护计划，以及政府通过直接财政支持与就业福利全面改革照护者薪酬体系。

**结论** 护理经济是一个新兴研究领域。部分地理区域的相关研究证据仍较为匮乏。现有研究多为短期或小样本研究，关于照护工作价值的实证证据极少。鉴于全球人口老龄化趋势日益加剧，亟需开展更多研究，以阐明正式与非正式护理人员为人群、社会及经济带来的积极影响。

**方案注册** 本研究方案已在开放科学框架（Open Science Framework, OSF）注册，注册号为10.17605，详细信息参见："Definitions, key themes and aspects of the care economy-a scoping review protocol," https://osf.io/ypmuh。