Understanding and measuring health care insecurity

Area of Science:

• Health Services Research
• Patient Experience
• Health Economics

Background:

• Health care insecurity (HCI) is a significant barrier for underserved populations.
• Existing measures may not fully capture the multifaceted nature of HCI.
• Free clinics play a crucial role in providing access to care for the uninsured.

Purpose of the Study:

• To define and conceptualize "health care insecurity."
• To validate a novel self-report instrument for measuring HCI.
• To evaluate the impact of initiating care at a free clinic on uninsured patients' HCI.

Main Methods:

• A 15-item self-report measure for HCI was administered to new patients at a free clinic.
• Psychometric properties, including internal consistency and validity, were assessed.
• Patients completed the measure at baseline and again 4-8 weeks later to examine changes.

Main Results:

• The HCI measure demonstrated high internal consistency (α=0.94).
• Concurrent validity was supported by correlations with quality of life and perceived stress measures.
• A significant reduction in HCI was observed after patients began receiving care at the free clinic (p<.001).

Conclusions:

• Reliable assessment of patient-reported health care insecurity is achievable.
• The validated HCI measure can inform interventions to enhance care quality and accessibility.
• Initiating care at free clinics effectively mitigates health care insecurity for vulnerable populations.