Addressing Health Insurance Literacy Gaps in an Urban African American Population: A Qualitative Study
Addressing Health Insurance Literacy Gaps in an Urban African American Population: A Qualitative Study
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DOI：
10.1007/s10900-018-0541-x
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发表时间：
2018-12-01
影响因子：
5.9
通讯作者：
Ayangeakaa, Suur D.
中科院分区：
文献类型：
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作者：
Ali, Nida M.;Combs, Ryan M.;Ayangeakaa, Suur D.
随着美国医疗保健系统的变化，医疗保险和医疗系统的扫盲需求也在不断变化。《平价医疗法案》实施后，肯塔基州西路易斯维尔的许多居民首次获得了医疗保险。进行了定性研究，以评估居民的健康保险和卫生系统的需求，并确定如何帮助居民导航的医疗保健系统和利用他们的健康保险覆盖面。共进行了12个焦点小组，共87名居民。第一轮探讨了参与者的健康保险经验，第二轮研究了他们的健康信息提供偏好。进行了归纳专题分析。参与者揭示了健康保险系统的复杂性，许多人引用了难以理解健康保险概念和找到合适的医疗服务提供者的问题。高成本，对医疗保健系统的不信任，以及感知到的公私差异是有效利用医疗保险的障碍。目前形式的健康保险材料在向西路易斯维尔人口提供健康保险和卫生系统信息方面价值有限。替代的信息提供形式，如当地可获得的和文化上胜任的社区卫生工作者，可能会更好地为社区所接受和更成功地利用。
Health insurance and health systems literacy needs are evolving with changes to the U.S. healthcare system. Following the implementation of the Affordable Care Act, many residents in West Louisville, Kentucky, a predominantly African American community, gained health insurance coverage for the first time. A qualitative study was conducted to assess residents' health insurance and health systems needs and to identify ways of assisting residents with navigating the healthcare system and utilizing their health insurance coverage. Twelve focus groups were conducted with a total of eighty-seven residents. Round one explored participants' experiences with health insurance, and round two examined their health information delivery preferences. An inductive thematic analysis was performed. Participants revealed the complexity of the health insurance system, many citing difficulty understanding health insurance concepts and finding suitable healthcare providers. High costs, mistrust in the healthcare system, and perceived public-private disparities were barriers to effective health insurance utilization. Health insurance materials in their current form have limited value in translating health insurance and health systems information to the West Louisville population. Alternative forms of information delivery, such as locally accessible and culturally competent community health workers may be better received and more successfully utilized by the community.