Comparing economic approaches to family caregiving valuation in Hong Kong China

Hong Kong’s rapidly ageing population and limited formal long-term care services place substantial reliance on unpaid family caregivers. Using cross-sectional survey data from 2284 family caregivers of adults aged ≥60 years in Hong Kong (2023–2024), this study compared caregiving costs estimated using the proxy good (PG), opportunity cost (OC), and contingent valuation (CV) methods. Family caregivers provided an average of 26 h of care per week (95% CI: 24.9–27.1). Estimated annual caregiving costs per caregiver were US$19,167 (PG), US$6,447 (OC), and US$37,622 (CV), corresponding to 1.51%, 0.51%, and 2.97% of Hong Kong’s GDP, respectively. Sensitivity analyses using median and trimmed willingness-to-accept (WTA) values modestly reduced CV estimates without changing the overall ranking of methods. Larger valuation gaps were observed among women, retired caregivers, co-residing caregivers, and caregivers supporting recipients aged >80 years or with functional or neurological conditions. The findings suggest that PG and OC primarily capture market replacement costs and forgone resources, whereas CV reflects broader subjective welfare dimensions associated with caregiving. Rather than representing competing estimates of a single underlying caregiving value, these approaches capture different dimensions of caregiving burden and should be interpreted as complementary valuation frameworks.