Affordability in individuals' healthcare decision making: A concept analysis

This concept analysis aims to define affordability within the context of healthcare decision making. Affordability is a complex concept that influences an individual's healthcare decision making. In the year's post-Affordable Care Act, the United States has seen an increase in insured individuals, but also an increase in underinsured healthcare consumers. Evidence for the concept attributes was found by searching the Cumulative Index of Nursing and Allied Health Literature, EconLit, Family & Society Studies Worldwide, Humanities Full Text, and PsychINFO databases. Literature was synthesized using the Walker and Avant approach. A new definition was derived with four defining attributes, as well as antecedents and consequences. Three cases are forwarded: the model, borderline, and contrary. In healthcare decision making, affordability is a subjective measure that individuals use in determining the ability to engage in a healthcare service or a durable good transaction. Affordability varies based on circumstances. The context of healthcare decision making of individuals stands in contrast to the decision-making in health systems and to decisions unrelated to one's health. Affordability is a determinant of an individual's ability to engage in a transaction. As such, nurses and policymakers should attempt to understand affordability from the patient's perspective.