Journal article
Association of Health Insurance Literacy with Health Care Utilization: a Systematic Review
Journal of general internal medicine : JGIM, Vol.37(2), pp.375-389
2022
DOI: 10.1007/s11606-021-06819-0
PMCID: PMC8141365
PMID: 34027605
Abstract
Background
Given increasing numbers of people experiencing transitions in health insurance due to declines in employer-sponsored insurance and changes in health policy, the understanding and application of health insurance terms and concepts (health insurance literacy) may be important for navigating use of health care. The study objective was to systematically review evidence on the relationship between health insurance literacy and health care utilization.
Methods
Medline, SCOPUS, Web of Science, CINAHL, PsychInfo, Cochrane Library, and reference lists of published literature were searched in August 2019. Quantitative, qualitative, and intervention studies that assessed the association of health insurance literacy as the exposure and health care utilization as the outcome were identified, without language or date restrictions. Outcomes were independently assessed by 2–3 reviewers.
Results
Twenty-one studies including a total of 62,416 subjects met inclusion criteria: three interventional trials, two mixed-methods studies, and sixteen cross-sectional studies. Ten of thirteen preventive care studies suggested that higher health insurance literacy was associated with greater utilization of primary care and other preventive services. Eight of nine studies of care avoidance demonstrated that individuals with lower health insurance literacy were more likely to delay or avoid care. A few studies had mixed results regarding the utilization of emergency department, inpatient, and surgical care.
Discussion
The emerging literature in this area suggests that health insurance literacy is an important factor that can enable effective utilization of health care, including primary care and preventive services. However, the literature is limited by a paucity of studies using validated tools that broadly measure health insurance literacy (rather than testing knowledge of specific covered services). Improving health insurance literacy of the general public and increasing plain language communication of health insurance plan features at the point of health care navigation may encourage more effective and cost-conscious utilization.
Details
- Title: Subtitle
- Association of Health Insurance Literacy with Health Care Utilization: a Systematic Review
- Creators
- Brian F. Yagi - University of Michigan–Ann ArborJamie E. Luster - University of Michigan–Ann ArborAaron M. Scherer - University of IowaMadeline R. Farron - University of Michigan–Ann ArborJudith E. Smith - University of Michigan–Ann ArborRenuka Tipirneni - University of Michigan–Ann Arbor
- Resource Type
- Journal article
- Publication Details
- Journal of general internal medicine : JGIM, Vol.37(2), pp.375-389
- Publisher
- Springer International Publishing
- DOI
- 10.1007/s11606-021-06819-0
- PMID
- 34027605
- PMCID
- PMC8141365
- ISSN
- 0884-8734
- eISSN
- 1525-1497
- Grant note
- K08AG056591 / National Institutes of Health (http://dx.doi.org/10.13039/100000002) University of Michigan Department of Internal Medicine
- Language
- English
- Date published
- 2022
- Academic Unit
- General Internal Medicine; Internal Medicine
- Record Identifier
- 9984359814102771
Metrics
22 Record Views