scholarly journals Health insurance coverage and cost barriers to needed medical care among U.S. adult cancer survivors age <65 years

Cancer ◽  
2006 ◽  
Vol 106 (11) ◽  
pp. 2466-2475 ◽  
Author(s):  
Susan A. Sabatino ◽  
Ralph J. Coates ◽  
Robert J. Uhler ◽  
Linda G. Alley ◽  
Lori A. Pollack
Keyword(s):  
Health Insurance ◽  
Cancer Survivors ◽  
Medical Care ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Adult Cancer Survivors

Autonomy, Coercion, and Public Healthcare Guarantees: The Uptake of Sofosbuvir in Germany

2020 ◽  
Vol 30 (1) ◽  
pp. 90-102
Author(s):  
AFSCHIN GANDJOUR
Keyword(s):  
Health Insurance ◽  
Medical Care ◽  
Reflective Equilibrium ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Public Healthcare ◽  
Recent Introduction

AbstractHealth insurance coverage for incarcerated citizens is generally acceptable by Western standards. However, it creates internal tensions with the prevailing justifications for public healthcare. In particular, a conceptualization of medical care as a source of autonomy enhancement does not align with the decreased autonomy of incarceration and the needs-based conceptualization of medical care in cases of imprisonment; and rejecting responsibility as a criterion for assigning medical care conflicts with the use of responsibility as a criterion for assigning punishment. The recent introduction of sofosbuvir in Germany provides a particularly instructive illustration of such tensions. It requires searching for a refined reflective equilibrium regarding the scope, limits, and justifications of publicly guaranteed care.

Health Insurance Coverage Disruptions and Access to Care and Affordability among Cancer Survivors in the United States

2020 ◽  
Vol 29 (11) ◽  
pp. 2134-2140
Author(s):  
Jingxuan Zhao ◽  
Xuesong Han ◽  
Leticia Nogueira ◽  
Zhiyuan Zheng ◽  
Ahmedin Jemal ◽  
...  
Keyword(s):  
United States ◽  
Health Insurance ◽  
Cancer Survivors ◽  
Access To Care ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States

Cancer history, health insurance coverage, and cost-related medication nonadherence and medication cost-coping strategies in the United States.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 68-68
Author(s):  
Jingxuan Zhao ◽  
Zhiyuan Zheng ◽  
Xuesong Han ◽  
Amy J. Davidoff ◽  
Matthew P. Banegas ◽  
...  
Keyword(s):  
Health Insurance ◽  
Cancer Survivors ◽  
Coping Strategies ◽  
Health Care Providers ◽  
Prescription Drugs ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Care Providers ◽  
Cancer History

68 Background: Policy makers, health care providers and patients are increasingly concerned about rising costs for prescription drugs and cost-related medication non-adherence (CRN). This study aims to evaluate the relationship between cancer history and CRN as well as cost-coping strategies, by health insurance coverage. Methods: We used the National Health Interview Survey data from 2013-2016 to identify adults age 18-64 with (n = 3 599) and without (n = 56 909) a cancer history. Cost-related changes in medication use included a) CRN (skipping, taking less or delaying medication because of cost), and b) cost-coping strategies (requesting lower cost medication or using alternative therapies to save money). Separate multivariable logistic regressions were used to calculate the adjusted percentages of CRN and cost-coping strategies associated with cancer history, stratified by health insurance. Results: Cancer survivors reported higher percentages of CRN (14.5% vs. 12.1%, P < .001) and were slightly more likely to report using cost-coping strategies (24.4% vs. 22.8%, P = .060) compared with adults without a cancer history. The magnitude of differences in CRN by cancer history varied by insurance type (any private 10.2% vs. 8.6%, P = .034; public only 17.9% vs. 14.2%, P = .010; uninsured 41.0% vs. 33.2%, P = .064). Among the privately insured, the difference in CRN by cancer history was greatest among those enrolled in high deductible health plans (HDHP) without health saving accounts (HSA) (16.9% vs. 10.9%, P = .002). Regardless of cancer history, CRN and use of cost-coping strategies were highest for those uninsured, enrolled in HDHP and without HSA, and without prescription drugs coverage under their health plan (all P < .001). Conclusions: Cancer survivors are prone to CRN and more likely to use cost-coping strategies to minimize financial hardship. Expanding options for health insurance coverage and use of HSA, and prescription drug coverage may be effective strategies to address CRN.

The association between health insurance coverage disruptions and access to care and affordability among cancer survivors in the United States.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 121-121
Author(s):  
Jingxuan Zhao ◽  
Xuesong Han ◽  
Leticia Maciel Nogueira ◽  
Ahmedin Jemal ◽  
K Robin Yabroff
Keyword(s):  
Health Insurance ◽  
Cancer Survivors ◽  
Access To Care ◽  
Insurance Coverage ◽  
Preventive Services ◽  
Health Insurance Coverage ◽  
The United States ◽  
Current Health ◽  
The Past ◽  
Services Use

121 Background: Having health insurance is a strong predictor of access to care and affordability. To date, most studies evaluating the effects of insurance coverage measured it only at a single time point. Little is known about the effects of coverage disruptions. This study aims to assess associations of a health insurance coverage disruption with access and affordability among cancer survivors in the United States. Methods: We identified 6476 cancer survivors aged 18-64 years with current health insurance coverage from the 2011-2017 National Health Interview Survey. Coverage disruption was measured by the question “In the past 12 months, was there any time when you did not have any health insurance or coverage?”. Access to care and affordability was measured by: 1) preventive services use (e.g. blood pressure check); and 2) forgoing care because of cost, respectively, in the past 12 months. We used separate multivariable logistic models to evaluate the associations between a coverage disruption and healthcare access and affordability, by current health insurance coverage. Results: Among survivors with current health insurance coverage, 3.7% of those with private and 8.1% with public insurance reported a coverage disruption in the past 12 months. Among survivors with current private coverage, those with a recent coverage disruption reported lower likelihood of any preventive services use (OR = 0.1, 95% CI: 0.1-0.3) and higher likelihood of forgoing any care because of cost (OR = 6.0, 95% CI: 3.9-9.5) compared to those with continuous private coverage. Among survivors with current public coverage, those with a recent coverage disruption reported lower likelihood of any preventive services use (OR = 0.4, 95% CI: 0.2-0.9) and higher likelihood of forgoing any care because of cost (OR = 4.3, 95% CI: 2.5-7.3) compared to those with continuous public coverage. Conclusions: Currently insured cancer survivors with a recent health insurance coverage disruption were more likely to report problems in access to care and affordability compared to the continuously insured. Improving private and public insurance coverage continuity may be effective in addressing these problems.

Linkage to HIV Medical Care and Social Determinants of Health Among Adults With Diagnosed HIV Infection in 41 States and the District of Columbia, 2017

2021 ◽  
pp. 003335492110299
Author(s):  
Myrline Gillot ◽  
Zanetta Gant ◽  
Xiaohong Hu ◽  
Anna Satcher Johnson
Keyword(s):  
Health Insurance ◽  
Hiv Infection ◽  
Medical Care ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Determinants Of Health ◽  
Hiv Care ◽  
Care Outcomes

Objectives To reduce the number of new HIV infections and improve HIV health care outcomes, the social conditions in which people live and work should be assessed. The objective of this study was to describe linkage to HIV medical care by selected demographic characteristics and social determinants of health (SDH) among US adults with HIV at the county level. Methods We used National HIV Surveillance System data from 42 US jurisdictions and data from the American Community Survey to describe differences in linkage to HIV medical care among adults aged ≥18 with HIV infection diagnosed in 2017. We categorized SDH variables into higher or lower levels of poverty (where <13% or ≥13% of the population lived below the federal poverty level), education (where <13% or ≥13% of the population had <high school diploma), and health insurance coverage (where <12% or ≥12% of the population lacked health insurance). We calculated prevalence ratios (PRs) and 95% CIs. Results Of 33 204 adults with HIV infection diagnosed in 2017, 78.4% were linked to HIV medical care ≤1 month after diagnosis. Overall, rates of linkage to care were significantly lower among men and women living in counties with higher versus lower poverty (PR = 0.96; 95% CI, 0.94-0.97), with lower versus higher health insurance coverage (PR = 0.93; 95% CI, 0.92-0.94), and with lower versus higher education levels (PR = 0.97; 95% CI, 0.96-0.98). Conclusions Increasing health insurance coverage and addressing economic and educational disparities would likely lead to better HIV care outcomes in these areas.

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