Beyond Being Insured: Insurance Coverage Denial as a Major Barrier to Accessing Care During Pregnancy and Postpartum

Date
2023-06-02
Authors
Lee, Jusung
Howard, Krista J.
Leong, Caleb
Grigsby, Timothy J.
Howard, Jeffrey T.
Journal Title
Journal ISSN
Volume Title
Publisher
SAGE Publications
Abstract

This study investigates the association between insurance coverage denial and delays in care during pregnancy and postpartum. An online survey was administered in March and April 2022 to women who were either pregnant or within 1 year postpartum (n = 1,113). The outcome was delayed care, measured at four time points: during pregnancy and 1 week, 2 to 6 weeks, and after 7 weeks postpartum. The key covariate was insurance coverage denial by providers during pregnancy. Delayed care due to having an unaccepted insurance and being “out-of-network” was more pronounced at 1 week postpartum with 3.37 times and 3.47 times greater odds and in 2 to 6 weeks postpartum with 5.74 times and 2.97 times greater odds, respectively. The association between insurance denial and delays in care encapsulated transportation, rural residency, time issues, and financial constraints. The findings suggest that coverage denial is associated with significant delays in care, providing practical implications for effective perinatal care.

Description
Keywords
delay in care, insurance coverage denial, financial constraints, transportation, rural
Citation
Lee, J., Howard, K. J., Leong, C., Grigsby, T. J., & Howard, J. T. (2023). Beyond Being Insured: Insurance Coverage Denial as a Major Barrier to Accessing Care During Pregnancy and Postpartum. Clinical Nursing Research, 32(8), 1092-1103. doi:10.1177/10547738231177332
Department
Public Health