Washington University School of Medicine, St. Louis, MO, USA.
Med Care Res Rev. 2021 Feb;78(1):48-56. doi: 10.1177/1077558718820232. Epub 2018 Dec 20.
This qualitative study explored cancer survivors' experiences selecting and using health insurance and anticipating out-of-pocket care costs. Thirty individuals participated in semistructured interviews. On average, participants were 54 years ( ± 8.85, range 34-80) and diagnosed with cancer about 5 years prior (range 0.5-10 years). About 57% were female, 77% were non-Hispanic White, and 53% had less than a college education. Participants struggled to access information about health insurance and costs. Lack of cost transparency made it difficult to anticipate expenses and increased anxiety. Many participants were surprised that after cancer, care that was once preventive with no out-of-pocket costs became diagnostic with associated fees. They discussed the cognitive burden of managing finances on top of treatment and overseeing communication between doctors and insurance. Interventions are needed to clearly communicate information about insurance coverage and care costs to improve cancer survivors' confidence in selecting health insurance and anticipating out-of-pocket expenses.
本定性研究探讨了癌症幸存者在选择和使用健康保险以及预测自付医疗费用方面的经验。30 名参与者参加了半结构化访谈。参与者的平均年龄为 54 岁（±8.85，范围 34-80），癌症诊断时间约为 5 年前（范围 0.5-10 年）。约 57%为女性，77%为非西班牙裔白人，53%的人受教育程度低于大学。参与者难以获取有关健康保险和费用的信息。缺乏成本透明度使得难以预测费用并增加了焦虑。许多参与者感到惊讶的是，癌症后，曾经没有自付费用的预防性保健现在变成了诊断性保健，并产生了相关费用。他们讨论了在治疗和监督医生与保险之间的沟通之外，管理财务的认知负担。需要进行干预，以清楚地传达有关保险范围和护理费用的信息，以提高癌症幸存者对选择健康保险和预测自付费用的信心。
