Improving Health Insurance Experiences for Adolescent and Young Adult Cancer Patients

改善青少年癌症患者的健康保险体验

• 批准号: 9978750
• 负责人: Anne C Kirchhoff
• 金额: $ 36.1万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-16 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9978750
• 关键词: Adolescent and Young Adult; Affordable Care Act; Age; Bankruptcy; Cancer Center; Cancer Patient; Caring; Collaborations; Communities; Diagnosis; Distress; Education; Enrollment; Ensure; Face; Financial Hardship; Goals; Grant; Health Care Costs; Health Insurance; Health Policy; Healthcare; Healthcare Systems; Individual; Institute of Medicine (U.S.); Institutes; Institution; Insurance; Insurance Coverage; Intervention; Interview; Joints; Letters; Malignant Neoplasms; Medical; Medical Care Costs; Modification; Oncology; Parents; Participant; Patients; Population; Provider; Randomized Controlled Trials; Recommendation; Reporting; Research; Sampling; Southwest Oncology Group; Structure; Telemedicine; Testing; Time; Underinsured; United States; Utah; Work; age related; base; cancer care; cancer diagnosis; cancer therapy; care costs; cost; experience; improved; interest; intervention program; literacy; program dissemination; programs; satisfaction; therapy design; treatment arm; treatment as usual; young adult

PROJECT ABSTRACT Cancer patients in the United States often experience severe distress about out-of-pocket costs due to their cancer treatment. Adolescent and young adult (AYA) cancer patients face more gaps in their health insurance coverage than older individuals with cancer. Medical costs have substantial effects on AYA cancer patients as studies show they are more likely to borrow money, go into debt, and file for bankruptcy after a cancer diagnosis than patients diagnosed with cancer at older ages. Improving health insurance and cost-related literacy – that is, a patient’s ability to make informed decisions about choosing and using health insurance, understanding financial concepts specific to care, and comfort discussing financial burden with providers – are necessary to ensuring AYA cancer patients receive high quality cancer care. The goal of this grant is to refine and pilot test an existing health insurance education program (HIEP) to improve insurance literacy and cost- related literacy among AYA cancer patients. We will identify age-related differences related to health insurance and cost literacy among AYAs diagnosed with cancer ages 18-39, and adapt the HIEP materials accordingly. We will conduct this study within the Huntsman-Intermountain Adolescent and Young Adult (HI-AYA) Cancer Care Program, which is a joint effort between the Huntsman Cancer Institute and Intermountain Healthcare. We will evaluate whether the HIEP delivered by the HI-AYA patient navigators improves AYA cancer patients’ health insurance and cost-related literacy compared to usual navigation care, which does not include education on insurance and costs. We aim to: 1) Adapt and refine a health insurance education program (HIEP) for AYA cancer patients. To inform adaptations to the existing intervention, we will conduct semi-structured interviews with AYA cancer patients (sampled within age of diagnosis: 18-26 years n=10; 27-39 years n=10) and pilot test the adapted HIEP with 10 AYA cancer patients. 2) Conduct a telemedicine-based pilot randomized controlled trial (RCT) of the HIEP among AYA cancer patients (n=80). Hypotheses: Among AYA cancer patients, the HIEP will be feasible and acceptable and improve their health insurance literacy and cost-related literacy compared to usual care. 3) Evaluate and refine the HIEP for dissemination in a larger RCT. We will conduct interviews with a randomly selected subset of HIEP intervention arm participants (18-26 years n=10; 27-39 years n=10) to understand their satisfaction, recommendations for modifications on delivery, and recommendations for intervention topics and content modifications. The long-term goals of this work are to 1) implement a sustainable health insurance education program that can be disseminated in oncology institutions throughout the United States and 2) influence health care policy about AYA cancer patients’ access to and use of health insurance and their medical costs.

项目摘要 美国的癌症患者经常因其自付费用而经常出现严重的困扰 癌症治疗。青少年和年轻人（AYA）癌症患者的健康保险差距更多 覆盖范围比老年人的癌症。医疗费用对AYA癌症患者产生重大影响，因为 研究表明，他们更有可能借钱，债务并申请癌症后破产 诊断比年龄较大的患者诊断。改善健康保险和与成本有关的 扫盲 - 也就是说，患者有能力做出有关选择和使用健康保险的明智决定的能力， 了解特定于护理的财务概念，并与提供者讨论财务燃烧的舒适感是 确保AYA癌症患者获得高质量的癌症护理所需的必要条件。这笔赠款的目的是完善 和试点测试现有的健康保险教育计划（HIEP），以提高保险素养和成本 - AYA癌症患者的相关识字率。我们将确定与健康保险有关的年龄相关差异 以及被诊断出18-39岁癌症的AYA的成本素养，并相应地适应HIEP材料。 我们将在Huntsman-Intermountain青少年和年轻人（HI-AYA）癌症中进行这项研究 护理计划，这是亨斯曼癌症研究所与Intermountain Healthcare之间的共同努力。 我们将评估HI-AYA患者导航员是否提供HIEP是否可以改善AYA癌症患者的患者。 与通常的导航护理相比，健康保险和与成本有关的识字率不包括教育 关于保险和费用。我们的目标是：1）适应和完善健康保险教育计划（HIEP） aya癌症患者。为了适应现有干预措施，我们将进行半结构化 对AYA癌症患者的访谈（诊断年龄在诊断年龄：18-26岁n = 10; 27-39; 27-39 n = 10） 并通过10名AYA癌症患者进行了试验测试改编的HIEP。 2）进行基于远程医疗的飞行员 AYA癌症患者中HIEP的随机对照试验（RCT）（n = 80）。假设：其中 AYA癌症患者，HIEP将是可行的，可以接受的，并提高其健康保险素养和 与通常的护理相比，与成本有关的识字率。 3）评估和完善HIEP以在较大的 RCT。我们将与随机选择的HIEP干预组参与者进行访谈（18-26 n = 10; 27-39岁n = 10）要了解他们的满意，建议交付的修改建议， 以及有关干预主题和内容修改的建议。这项工作的长期目标是 1）实施可持续的健康保险教育计划，可以在肿瘤学中传播 美国各地的机构和2）影响有关AYA癌症患者访问的医疗保健政策 进行健康保险及其医疗费用。