健康保险知识：种族、民族和语言偏好差异。

Health insurance literacy: disparities by race, ethnicity, and language preference.

机构信息

University of Connecticut Health Disparities Institute, 241 Main St, 5th Floor, Hartford, CT 06106. Email:

出版信息

Am J Manag Care. 2019 Mar 1;25(3):e71-e75.

Abstract

OBJECTIVES

To measure Connecticut's Affordable Care Act qualified health plan enrollees' health insurance literacy (HIL) by race, ethnicity, and language preference.

STUDY DESIGN

Statewide landline and cell phone telephonic survey.

METHODS

Geographically balanced cohort that oversampled black and Hispanic enrollees. Questions tested enrollees' knowledge of basic health insurance terminology and their use. Survey data were supplemented by deidentified administrative data from the state's health insurance exchange.

RESULTS

Overall, subjects answered 62% of 13 questions correctly. The percentages of correct answers were 53% for black enrollees, 50% for Hispanic enrollees, 74% for white enrollees, and 45% for Spanish-speaking enrollees. The differences by race, ethnicity, and language preference were statistically significant. Overall, enrollees with a college education scored higher across all demographic groups, but disparities by race and ethnicity persisted.

CONCLUSIONS

Health insurance terminology and use rules confuse consumers, especially racial and ethnic minorities. Differences in HIL may be a previously underrecognized source of healthcare disparities because even minor errors can result in delayed care or unanticipated medical bills. Low HIL can diminish the practical value of health insurance and exacerbate perceptions of health insurance as offering insufficient value for premium price. Additional research on ways to improve HIL and investments in insurance navigation support for black and Hispanic enrollees are needed.

摘要

目的

通过种族、族裔和语言偏好来衡量康涅狄格州平价医疗法案合格健康计划参保者的健康保险素养 (HIL)。

研究设计

全州固定电话和手机电话调查。

方法

采用地理平衡队列对黑人和西班牙裔参保者进行了超额抽样。问题测试了参保者对基本健康保险术语的了解程度及其使用情况。调查数据由该州健康保险交易所的匿名行政数据补充。

结果

总体而言，受试者正确回答了 13 个问题中的 62%。黑人参保者的正确回答率为 53%，西班牙裔参保者为 50%，白人参保者为 74%，西班牙语参保者为 45%。种族、族裔和语言偏好的差异具有统计学意义。总体而言，受过大学教育的参保者在所有人群中得分都更高，但种族和族裔差异仍然存在。

结论

健康保险术语和使用规则让消费者感到困惑，尤其是少数族裔。健康保险素养的差异可能是以前未被认识到的医疗保健差异的一个来源，因为即使是微小的错误也可能导致延迟治疗或意外的医疗费用。低健康保险素养会降低健康保险的实际价值，并加剧人们对健康保险保费价值不足的看法。需要进一步研究提高健康保险素养的方法，并为黑人和西班牙裔参保者投资保险导航支持。