Beyond Being Insured: Insurance Coverage Denial as a Major Barrier to Accessing Care During Pregnancy and Postpartum.
Jusung Lee, Krista J Howard, Caleb Leong and 2 others
PMID 37264856WHAT IT FOUND
Women whose insurance was not accepted or out of network reported delayed care more often than women without insurance problems, especially in the first 6 weeks postpartum.
Financial barriers stayed linked to delay throughout.
Key findings
01After adjustment, provider non-acceptance of insurance was associated with more delayed care during pregnancy and early postpartum.
02Delayed care was common during pregnancy and declined after birth: 72.7% during pregnancy, 50.3% at 1 week, 46.1% at 2 to 6 weeks, and 37.6% after 7 weeks postpartum.
03Financial constraints stayed associated with delayed care across all periods, while transportation, rural residence, and time issues were associated mainly in early postpartum.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
18,900 were invited and 1,280 completed; the paper reports a 46.7% response rate, so nonresponders may differ. This was a one-time cross-sectional survey, so it cannot show that insurance denial caused delayed care. It relied on self-report, with possible recall and social desirability bias. It did not examine delays by trimester or use clinical records. It was conducted during the COVID-19 pandemic, but the study did not test pandemic effects. Other unmeasured factors could explain some associations.
Declared interests
The authors declared no potential conflicts of interest. The study was funded in part by the Lutcher Brown Fellowship through the University of Texas at San Antonio.
The easy way to misread this
Do not conclude that insurance denial caused delayed care. This was a cross-sectional survey, so it shows association, not cause and effect.