Abstract
AbstractChanges in health insurance coverage may disrupt access to and continuity of care, even for those who remain insured. Continuity of care is especially important in schizophrenia, which requires ongoing medical and pharmaceutical treatment. However, little is known about continuity of insurance coverage among those with schizophrenia. The objective was to examine the probability of insurance transitions for individuals with schizophrenia who were continuously insured and whether this varied across insurance types. The Massachusetts All-Payer Claims Database identified individuals with schizophrenia aged 18–64 who were continuously insured during a two-year period between 2014 and 2018. A logistic regression estimated the association of having an insurance transition – defined as having a change in insurance type – with insurance type at the start of the period, adjusting for age, sex, ZIP code in the lowest quartile of median income, and ZIP code with concentrated poverty. Overall, 15.1% had at least one insurance transition across a 24-month period. Insurance transitions were most frequent among those with plans from the Marketplace. In regression adjusted results, individuals covered by the traditional Medicaid program were 20.2 percentage points [pp] (95% confidence interval [CI]: 24.6 pp, 15.9 pp) less likely to have an insurance transition than those who were insured by a Marketplace plan. Insurance transitions among individuals with schizophrenia were common, with more than one in six people having at least one transition in insurance type during a two-year period. Given that even continuously insured individuals with schizophrenia commonly experience insurance transitions, attention to insurance transitions as a barrier to care access and continuity is warranted.
Funder
U.S. Department of Health & Human Services | NIH | National Institute of Mental Health
Publisher
Springer Science and Business Media LLC
Reference60 articles.
1. Puntis, S., Rugkåsa, J., Forrest, A., Mitchell, A. & Burns, T. Associations between continuity of care and patient outcomes in mental health care: a systematic review. Psychiatr. Serv. 66, 354–363 (2015).
2. National Institute of Mental Health. Schizophrenia, https://www.nimh.nih.gov/health/statistics/schizophrenia
3. Villarroel, M. A. & Cohen, R. A. Health Insurance Continuity and Health Care Access and Utilization, 2014. NCHS Data Brief 249, 1–8 (2016).
4. Khaykin, E., Eaton, W. W., Ford, D. E., Anthony, C. B. & Daumit, G. L. Health insurance coverage among persons with schizophrenia in the United States. Psychiatr. Serv. 61, 830–834 (2010).
5. Geissler, K. H., Ericson, K. M., Simon, G. E., Qian, J. & Zeber, J. E. Differences in Insurance Coverage for Individuals With Schizophrenia After Implementation of the Patient Protection and Affordable Care Act. JAMA Psychiatry 80, 278–279 (2023).
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