Measurement of Health Insurance Literacy and Identification of Its Correlates Among Working-Age Cancer Survivors in the US
Author(s)
Korgaonkar S1, Bentley J2, Holmes E2, Barnard M2, Ramachandran S3, Chang Y4, Yang Y2
1RTI Health Solutions, Research Triangle Park, NC, USA, 2Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, University, MS, USA, 3Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, University, MS, USA, 4University of Mississippi School of Applied Sciences, University, MS, USA
Presentation Documents
OBJECTIVES: To measure health insurance literacy (HIL) of working-age cancer survivors (WACS) in the US and identify its sociodemographic and health insurance-related correlates.
METHODS: Data were collected from a national convenience sample of cancer survivors through an online survey from January to March 2022. Respondents were required to be aged 27-64 years and currently receiving/received cancer treatment within last five years. HIL was measured using the 21-item HIL Measure with four subscales: Confidence Choosing Health Plans (Confidence-CHP), Confidence Using Health Plans (Confidence-UHP), Comparing Health Plans (Compare-HP), and Proactive Use of Health Plans (Proactive-UHP). Correlates of HIL assessed included sociodemographic characteristics, financial skills (FS) (measured using the 5-item Financial Skills Scale), and health insurance challenges (HICs) experienced in past twelve months. Multivariable general linear models were used to evaluate associations between respondent characteristics and standardized HIL scores (i.e., Y-standardization).
RESULTS: The final sample had 309 WACS (median age: 52 years, 70.9% female, 80.9% White). With a possible range of 0-4, the mean (SD) overall HIL score was 2.83 (0.67). Mean (SD) subscale scores were: Confidence-CHP [2.48 (0.83)], Confidence-UHP [2.43 (0.94)], Compare-HP [3.35 (0.79)], and Proactive-UHP [3.06 (0.77)]. Younger age (27-40 years) was associated with lower HIL [estimate: -0.325, 95% confidence interval (CI): -0.579 to -0.071]. A majority (61.5%) of respondents reported experiencing ≥1 HIC. Most common HICs were difficulty seeking authorization for healthcare services/drugs (37.9%) and seeking information about covered services and insurance payments from health plans (32.0%). Past experience of HICs was associated with lower HIL [estimate: -0.266, 95% CI: -0.478 to -0.054], while FS scores were positively associated with HIL [estimate: 0.043, 95% CI: 0.035 to 0.051].
CONCLUSIONS: WACS demonstrated moderate HIL mainly driven by lower confidence regarding health plan selection and utilization. This finding highlights an interventional area for cancer patient empowerment and HIL education, especially among younger WACS in the US.
Conference/Value in Health Info
Value in Health, Volume 27, Issue 6, S1 (June 2024)
Code
PCR265
Topic
Methodological & Statistical Research, Patient-Centered Research
Topic Subcategory
Patient Behavior and Incentives, Patient-reported Outcomes & Quality of Life Outcomes, PRO & Related Methods
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology