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: 10204974
• 负责人: Anne C Kirchhoff
• 金额: $ 35.66万
• 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 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10204974
• 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自付费用而遭受严重困扰，因为他们 青少年和年轻成人 (AYA) 癌症患者的健康保险面临更多缺口。 医疗费用对 AYA 癌症患者有重大影响，因为 研究表明，他们在患癌症后更有可能借钱、负债和申请破产 与年龄较大时诊断出癌症的患者相比，改善健康保险和费用相关。 素养——即患者就选择和使用健康保险做出明智决定的能力， 了解特定于护理的财务概念，并与提供者轻松讨论财务负担 – 是 确保 AYA 癌症患者获得高质量的癌症护理是必要的。这笔赠款的目标是完善。 并试点测试现有的健康保险教育计划（HIEP），以提高保险知识和成本 AYA 癌症患者的相关素养 我们将确定与健康保险相关的年龄差异。 18-39 岁被诊断患有癌症的 AYA 的识字成本和成本，并相应地调整 HIEP 材料。 我们将在 Huntsman-Intermountain 青少年和年轻人 (HI-AYA) 癌症中心进行这项研究 护理计划是亨斯迈癌症研究所和 Intermountain Healthcare 共同努力的项目。 我们将评估 HI-AYA 患者导航仪提供的 HIEP 是否可以改善 AYA 癌症患者的病情 与不包括教育的常规导航护理相比，健康保险和与成本相关的识字能力 我们的目标是： 1) 调整和完善健康保险教育计划 (HIEP) 为了让 AYA 癌症患者适应现有的干预措施，我们将进行半结构化。 对 AYA 癌症患者的访谈（在诊断年龄内抽样：18-26 岁 n=10；27-39 岁 n=10） 并在 10 名 AYA 癌症患者中对改编后的 HIEP 进行试点测试 2) 进行基于远程医疗的试点。 AYA 癌症患者的 HIEP 随机对照试验 (RCT)（n=80）。 对于 AYA 癌症患者，HIEP 将是可行且可接受的，并提高他们的健康保险素养和 与常规护理相比，成本相关的识字能力 3) 评估和完善 HIEP，以便在更大范围内传播。 RCT。我们将对随机选择的 HIEP 干预组参与者（18-26 岁）进行访谈。 年龄 n=10；27-39 岁 n=10) 了解他们的满意度、交付修改建议， 以及干预主题和内容修改的建议 这项工作的长期目标是 1）实施可在肿瘤学领域传播的可持续健康保险教育计划 美国各地的机构以及 2) 影响有关 AYA 癌症患者获取的医疗保健政策 健康保险的使用和使用及其医疗费用。