Understanding and measuring health care insecurity

Philip E. Tomsik, Samantha Smith, Mary Jane Mason, Stephen J. Zyzanski, Kurt C. Stange, James J. Werner, Sue Flocke

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose. To define the concept of “health care insecurity,” validate a new selfreport measure, and examine the impact of beginning care at a free clinic on uninsured patients’ health care insecurity. Methods. Consecutive new patients presenting at a free clinic completed 15 items assessing domains of health care insecurity (HCI) at their first visit and again four to eight weeks later. Psychometrics and change of the HCI measure were examined. Results. The HCI measure was found to have high internal consistency (α=0.94). Evidence of concurrent validity was indicated by negative correlation with VR-12 health-related quality of life physical and mental health components and positive correlation with the Perceived Stress Scale. Predictive validity was shown among the 83% of participants completing follow-up: HCI decreased after beginning care at a free clinic (p<.001). Conclusion. Reliably assessing patient experience of health care insecurity is feasible and has potential to inform efforts to improve quality and access to care among underserved populations.

Original languageEnglish (US)
Pages (from-to)1821-1832
Number of pages12
JournalJournal of Health Care for the Poor and Underserved
Volume25
Issue number4
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Delivery of Health Care
Aftercare
Vulnerable Populations
Psychometrics
Patient Care
Mental Health
Quality of Life

Keywords

  • Disparities
  • Health care
  • Health services
  • Inequality
  • Insecurity

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Tomsik, P. E., Smith, S., Mason, M. J., Zyzanski, S. J., Stange, K. C., Werner, J. J., & Flocke, S. (2014). Understanding and measuring health care insecurity. Journal of Health Care for the Poor and Underserved, 25(4), 1821-1832. https://doi.org/10.1353/hpu.2014.0180

Understanding and measuring health care insecurity. / Tomsik, Philip E.; Smith, Samantha; Mason, Mary Jane; Zyzanski, Stephen J.; Stange, Kurt C.; Werner, James J.; Flocke, Sue.

In: Journal of Health Care for the Poor and Underserved, Vol. 25, No. 4, 01.01.2014, p. 1821-1832.

Research output: Contribution to journalArticle

Tomsik, PE, Smith, S, Mason, MJ, Zyzanski, SJ, Stange, KC, Werner, JJ & Flocke, S 2014, 'Understanding and measuring health care insecurity', Journal of Health Care for the Poor and Underserved, vol. 25, no. 4, pp. 1821-1832. https://doi.org/10.1353/hpu.2014.0180
Tomsik PE, Smith S, Mason MJ, Zyzanski SJ, Stange KC, Werner JJ et al. Understanding and measuring health care insecurity. Journal of Health Care for the Poor and Underserved. 2014 Jan 1;25(4):1821-1832. https://doi.org/10.1353/hpu.2014.0180
Tomsik, Philip E. ; Smith, Samantha ; Mason, Mary Jane ; Zyzanski, Stephen J. ; Stange, Kurt C. ; Werner, James J. ; Flocke, Sue. / Understanding and measuring health care insecurity. In: Journal of Health Care for the Poor and Underserved. 2014 ; Vol. 25, No. 4. pp. 1821-1832.
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