Health insurance literacy: A mixed methods study of college students

Nobles, Alicia L.; Curtis, Brett A; Ngo, Duc Anh; Vardell, Emily; Holstege, Christopher P.

doi:10.1080/07448481.2018.1486844

Cited by 25 publications

(24 citation statements)

References 10 publications

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“…For example, those with limited education are often found to have inadequate levels of HIL, yet studies with college students and young adults with high educational attainment, numeracy, and general literacy have been found to have inadequate functional HIL, (Nobles, Curtis, Ngo, Vardell, & Holstege, 2019; Tilley, Yarger, & Brindis, 2018). This emphasizes the need to better address the HIL needs of young adults, especially those who are entering the workforce, transitioning from their parent's health insurance plans, and/or making independent health insurance coverage decisions.…”

Section: Discussionmentioning

confidence: 99%

Significant Disparities Exist in Consumer Health Insurance Literacy: Implications for Health Care Reform

Edward¹,

Wiggins²,

Young³

et al. 2019

HLRP: Health Literacy Research and Practice

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Background: Health insurance literacy (HIL) is defined as a person's ability to seek, obtain, and understand health insurance plans, and once enrolled use their insurance to seek appropriate health care services. Objective: The objectives of this study were to assess sociodemographic disparities in HIL, including knowledge of health insurance terms and costs, and confidence in using insurance to access health care in a nationally representative adult sample. Methods: We conducted a secondary data analysis of the Health Reform Monitoring Survey, which included 15,168 adults age 18 years and older who responded to surveys in the third quarter of 2015 and first quarter of 2016. Rao-Scott chi-square tests and weighted logistic regression were used for analysis. Key Results: The majority of our sample (51%) reported having inadequate HIL as measured by knowledge of basic insurance terms, and close to one-half (48%) had low confidence in using their insurance to access health care. Logistic regression analysis indicated significant disparities in HIL, with multiple groups identified as being at higher risk for having inadequate HIL (as measured by both knowledge and use of health insurance). These included young adults, women, those with Hispanic ethnicity, those who were not U.S. citizens, and those who were currently unmarried. Also identified to be at risk were those who are unemployed, uninsured, and enrolled in public health insurance plans, and those with lower levels of education and income. Most had inadequate knowledge of their annual out-of-pocket costs and insurance plan's deductible amounts. Conclusions: One-half of U.S. adults rate themselves as having inadequate HIL. Sociodemographic disparities in self-reported HIL underscore the need for increased consumer education, as well as efforts to simplify the health care system by promoting value-based care, supporting delivery system reforms, and designing services to be responsive to consumer HIL needs and abilities. [ HLRP: Health Literacy Research and Practice . 2019;3(4):e250–e258.] Plain Language Summary: In a nationally representative sample of 15,168 adults, the majority had low knowledge about basic health insurance terms and had difficulty using health insurance to access needed health care services. These findings indicate that health insurance literacy is a major concern in our community that disproportionately affects some underserved groups more than others, including young adults, groups with low-income, and people who are uninsured.

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Section: Discussionmentioning

confidence: 99%

Significant Disparities Exist in Consumer Health Insurance Literacy: Implications for Health Care Reform

Edward¹,

Wiggins²,

Young³

et al. 2019

HLRP: Health Literacy Research and Practice

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“…Newly insured = α 0 +α 1 insured + α 2 usurious borrowing + α 3 ill + Xβ + u (1) non-usurious borrowing = μ 0 + μ 1 newly insured +Xγ+ v (2) Where, newly insured, insured, usurious borrowing, non-usurious borrowing, and ill are dummy variables that capture whether a decision to be newly insured was taken, whether or not the household was already insured, whether or not a household engaged in usurious borrowing, whether or not a household engaged in non-usurious borrowing, and whether or not a household saw illness in the family in a recent past. X is a vector of covariates (including education level) associated with the coefficient vectors β and γ in regressions (1) and (2). u and v are stochastic error terms.…”

Section: Results Of the Regression Analysismentioning

confidence: 99%

“…The lack of a feeling of necessity (noted at the very end of the previous quote), often presents itself as a hindrance to insurance buying. For example, in a recent study, 2 it is observed that half the respondents indicated confusion about their health insurance plans, often leading to the delay or a complete foregoing of medical care. Therefore, targeted outreach and education programmes for buyers of insurance products are often recommended to fill in these 'knowledge deficits. '…”

Section: Key Messagesmentioning

confidence: 99%

“…Authors' affiliations 1 Manipal Institute of Management, Centre for Advanced Research in Financial Inclusion, Manipal Academy of Higher Education, Manipal, Karnataka, India. 2 University of Melbourne (Australia India Institute), Melbourne, VIC, Australia.…”

Section: Ethical Issuesmentioning

confidence: 99%

“…A considerable amount of emphasis is being put on the need to educate consumers on the merits of a product, 1 “particularly in this age of rampant misinformation, a disinterested public, or the genuine possibility that customers simply don’t believe they need a given product.” The lack of a feeling of necessity (noted at the very end of the previous quote), often presents itself as a hindrance to insurance buying. For example,in a recent study, 2 it is observed that half the respondents indicated confusion about their health insurance plans, often leading to the delay or a complete foregoing of medical care.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Education and Experience as Determinants of Micro Health Insurance Enrolment

Basri

Banerjee

2020

Int J Health Policy Manag

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Background: India faces a formidable challenge of providing universal health coverage to its uninsured population in the informal sector of the economy. Numerous micro health insurance (MHI) schemes have emerged as health financing mechanisms to reduce medical-illness-induced poverty. Existing research shows that the purchase of health insurance is most likely to be determined by health status, expected healthcare expenditure, and past health experiences in addition to socio-economic variables. We add to the understanding of various factors influencing enrolment in MHI from an Indian perspective. Methods: A survey was carried out to collect quantitative data in three districts in the state of Karnataka, India. Results: We show that education does not matter as significantly as experience does, in the determination of new insurance purchases. In other words, the importance of new insurance is not understood by those who are merely educated, but by those who have either fallen ill, or have previously seen the hazards of usurious borrowing. Conclusion: Our study provides deeper insights into the role of usurious borrowing and past illness in determining insurance purchases and highlights the formidable challenge of financial sustainability in the MHI market of India.

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Health insurance for university students in Bangladesh: A novel experiment

Hamid

Khanam

Azim

et al. 2021

Health Science Reports

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Background and Aims Bangladesh requires some pragmatic initiatives for using its immense potentiality to flourish health insurance. Introducing group health insurance for university students is a groundbreaking idea for stepping toward social health insurance in Bangladesh. This article examined the effect of the health insurance initiative for the university students introduced by the Institute of Health Economics, University of Dhaka, on attitude toward insurance and protecting financial risk against health care expenditure. Method We used both management information system (MIS) and primary data obtained through mixed methods. We collected the quantitative data from a baseline survey on 310 students and a year‐end survey on 151 students. We used bivariate tools to analyze the data. Results The results show that the mean score of attitude toward health insurance in the year‐end survey (4.04) was significantly higher than the baseline score (3.21). Results also show that a significantly higher percentage of the students reported insurance as “useful” in the year‐end survey (83.74%) than the baseline survey (40.40%). The results also reflectes that the scheme has a substantial impact on reducing the out‐of‐pocket spending for health care, especially for in‐patient care, and the anxiety regarding the financing of health care among the students. There is also an indication of sustainability and the feasibility of scaling up such a scheme across the country. Conclusions Introducing such health insurance by all the universities may guide the nation toward large‐scale group health insurance and social health insurance.

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Health insurance literacy: A mixed methods study of college students

Abstract: Outreach and education for students should target specific deficits in knowledge such as those identified in this study.

Cited by 25 publications

References 10 publications

Significant Disparities Exist in Consumer Health Insurance Literacy: Implications for Health Care Reform

Significant Disparities Exist in Consumer Health Insurance Literacy: Implications for Health Care Reform

Education and Experience as Determinants of Micro Health Insurance Enrolment

Health insurance for university students in Bangladesh: A novel experiment

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