School of Nursing, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, USA.
Nurs Forum. 2021 Jan;56(1):188-193. doi: 10.1111/nuf.12518. Epub 2020 Oct 31.
This concept analysis aims to define affordability within the context of healthcare decision making. Affordability is a complex concept that influences an individual's healthcare decision making. In the year's post-Affordable Care Act, the United States has seen an increase in insured individuals, but also an increase in underinsured healthcare consumers. Evidence for the concept attributes was found by searching the Cumulative Index of Nursing and Allied Health Literature, EconLit, Family & Society Studies Worldwide, Humanities Full Text, and PsychINFO databases. Literature was synthesized using the Walker and Avant approach. A new definition was derived with four defining attributes, as well as antecedents and consequences. Three cases are forwarded: the model, borderline, and contrary. In healthcare decision making, affordability is a subjective measure that individuals use in determining the ability to engage in a healthcare service or a durable good transaction. Affordability varies based on circumstances. The context of healthcare decision making of individuals stands in contrast to the decision-making in health systems and to decisions unrelated to one's health. Affordability is a determinant of an individual's ability to engage in a transaction. As such, nurses and policymakers should attempt to understand affordability from the patient's perspective.
本概念分析旨在确定医疗决策背景下的可负担性。可负担性是一个复杂的概念，影响个人的医疗决策。在《平价医疗法案》通过后的几年里，美国的参保人数有所增加，但未参保的医疗消费者人数也有所增加。通过搜索 Cumulative Index of Nursing and Allied Health Literature、EconLit、Family & Society Studies Worldwide、Humanities Full Text 和 PsychINFO 数据库，找到了该概念属性的证据。文献综合使用了 Walker 和 Avant 方法。得出了一个新的定义，其中包含四个定义属性以及前提和后果。提出了三个案例：模型、边界和相反。在医疗决策中，可负担性是个人用来确定参与医疗服务或耐用商品交易能力的主观衡量标准。可负担性因情况而异。个人的医疗决策背景与医疗系统的决策以及与个人健康无关的决策形成对比。可负担性是个人参与交易能力的决定因素。因此，护士和政策制定者应该从患者的角度来理解可负担性。
