The impact of insurance on adolescent transition to adult care
Background: This study sought to examine how adolescents and young adults with special health care needs (AYA) prepare for managing medical insurance (private and public) as an adult and the role of insurance in locating an adult provider and engaging in care. Methods: Twenty-eight AYA aged 18–24 ye...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-01-01
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| Series: | Health Care Transitions |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2949923225000145 |
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| author | Diane V. Murrell Cassandra J. Enzler Lauren Bretz Beth H. Garland Albert C. Hergenroeder Christine Markham Constance M. Wiemann |
| author_facet | Diane V. Murrell Cassandra J. Enzler Lauren Bretz Beth H. Garland Albert C. Hergenroeder Christine Markham Constance M. Wiemann |
| author_sort | Diane V. Murrell |
| collection | DOAJ |
| description | Background: This study sought to examine how adolescents and young adults with special health care needs (AYA) prepare for managing medical insurance (private and public) as an adult and the role of insurance in locating an adult provider and engaging in care. Methods: Twenty-eight AYA aged 18–24 years with renal, inflammatory bowel, or rheumatologic diseases completed individual semi-structured interviews designed to evaluate the impact of insurance (private vs. public) on their health care transition experiences. An interdisciplinary team of coders analyzed transcripts using The Framework Method. Results: Three themes emerged: continuum of accepting health insurance responsibility; the impact of insurance on managing health while transitioning to an adult provider; and how insurance systems affect transition. AYA described a continuum of the adolescent increasing health insurance responsibility, which was paralleled by their parent/caregiver’s continuum of decreasing insurance responsibility. Both publicly and privately insured AYA faced difficulties in transition related to insurance and reported that insurance was a key deciding factor in locating providers and centers to receive care. Regardless of insurance type, some AYA also described financial difficulties affording care. Conclusions: Health insurance is a complex system that affects AYA’s ability to manage their health and transition to adult-based care. Evidence-based interventions to improve AYA and parent/caregiver health literacy knowledge and skills about health insurance prior to transition to adult-based care are needed. Improvement in health insurance literacy could improve transition readiness for entering adult care, which could in turn improve health outcomes. |
| format | Article |
| id | doaj-art-e6a2ca907c984a28b2efaaeb5461fa12 |
| institution | DOAJ |
| issn | 2949-9232 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Health Care Transitions |
| spelling | doaj-art-e6a2ca907c984a28b2efaaeb5461fa122025-08-20T03:22:30ZengElsevierHealth Care Transitions2949-92322025-01-01310010810.1016/j.hctj.2025.100108The impact of insurance on adolescent transition to adult careDiane V. Murrell0Cassandra J. Enzler1Lauren Bretz2Beth H. Garland3Albert C. Hergenroeder4Christine Markham5Constance M. Wiemann6Division of Neurology, Texas Children’s Hospital, 6701 Fannin, Suite 940, Houston, TX 77030, USA; Correspondence to: Division of Neurology, Texas Children’s Hospital, 6701 Fannin St, Suite 950, Houston, TX 77030, USA.Division of Adolescent Medicine & Sports Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, 6701 Fannin, Suite 1710, Houston, TX 77030, USADivision of Adolescent Medicine & Sports Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, 6701 Fannin, Suite 1710, Houston, TX 77030, USADivisions of Adolescent Medicine & Sports Medicine and Pediatric Psychology, Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, 6701 Fannin, Suite 1710, Houston, TX 77030, USADivision of Adolescent Medicine & Sports Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, 6701 Fannin, Suite 1710, Houston, TX 77030, USADepartment of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health, 7000 Fannin, Suite 2622, Houston, TX 77030, USADivision of Adolescent Medicine & Sports Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, 6701 Fannin, Suite 1710, Houston, TX 77030, USABackground: This study sought to examine how adolescents and young adults with special health care needs (AYA) prepare for managing medical insurance (private and public) as an adult and the role of insurance in locating an adult provider and engaging in care. Methods: Twenty-eight AYA aged 18–24 years with renal, inflammatory bowel, or rheumatologic diseases completed individual semi-structured interviews designed to evaluate the impact of insurance (private vs. public) on their health care transition experiences. An interdisciplinary team of coders analyzed transcripts using The Framework Method. Results: Three themes emerged: continuum of accepting health insurance responsibility; the impact of insurance on managing health while transitioning to an adult provider; and how insurance systems affect transition. AYA described a continuum of the adolescent increasing health insurance responsibility, which was paralleled by their parent/caregiver’s continuum of decreasing insurance responsibility. Both publicly and privately insured AYA faced difficulties in transition related to insurance and reported that insurance was a key deciding factor in locating providers and centers to receive care. Regardless of insurance type, some AYA also described financial difficulties affording care. Conclusions: Health insurance is a complex system that affects AYA’s ability to manage their health and transition to adult-based care. Evidence-based interventions to improve AYA and parent/caregiver health literacy knowledge and skills about health insurance prior to transition to adult-based care are needed. Improvement in health insurance literacy could improve transition readiness for entering adult care, which could in turn improve health outcomes.http://www.sciencedirect.com/science/article/pii/S2949923225000145Adolescents and young adults with special health-care needsInsuranceHealth-care transitionQualitative researchHealth literacy |
| spellingShingle | Diane V. Murrell Cassandra J. Enzler Lauren Bretz Beth H. Garland Albert C. Hergenroeder Christine Markham Constance M. Wiemann The impact of insurance on adolescent transition to adult care Health Care Transitions Adolescents and young adults with special health-care needs Insurance Health-care transition Qualitative research Health literacy |
| title | The impact of insurance on adolescent transition to adult care |
| title_full | The impact of insurance on adolescent transition to adult care |
| title_fullStr | The impact of insurance on adolescent transition to adult care |
| title_full_unstemmed | The impact of insurance on adolescent transition to adult care |
| title_short | The impact of insurance on adolescent transition to adult care |
| title_sort | impact of insurance on adolescent transition to adult care |
| topic | Adolescents and young adults with special health-care needs Insurance Health-care transition Qualitative research Health literacy |
| url | http://www.sciencedirect.com/science/article/pii/S2949923225000145 |
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