Cover Image
QR Code

A conceptual model of health insurance stability in the United States health care system.

In the U.S. health care system, people under age 65 are at risk of losing and regaining health insurance coverage over their lifetimes, which has important consequences for their physical and mental health. Despite the importance of insurance stability, we have an incomplete understanding about the...

Full description

Published in:Health Services Management Research Vol. 36; no. 3; pp. 205 - 215
Main Authors: Grembowski, David, Leibbrand, Christine
Format: tables/charts Journal Article
Published: Sage Publications Inc. Aug2023
Online Access:View this record in EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=164710174&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 164710174
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        09514848
        8O8
      jtl: Health Services Management Research
      issn: 09514848
      maglogo: N
    pubinfo:
      dt: Aug2023
      vid: 36
      iid: 3
      pid: 344
      pub: Sage Publications Inc.
      place: Thousand Oaks, California
    artinfo:
      ui:
        164710174
        160862503
        164710174
        164710174
        10.1177/09514848221146677
        164710174
      ppf: 205
      ppct: 10
      formats:
      tig:
        atl: A conceptual model of health insurance stability in the United States health care system.
      aug:
        au:
          Grembowski, David
          Leibbrand, Christine
        affil: Health Systems and Population Health, 7284 University of Washington, Seattle, WA, USA
      sug:
        subj:
          Insurance, Health United States
          Insurance Coverage
          Health Services Accessibility
          Models, Theoretical
          United States
          Social Environment
          Social Capital
          Geographic Factors
          Health Policy
          Health Insurance Exchanges
          Employment Status
          Health Status
          Social Status
          Socioeconomic Factors
      ab: In the U.S. health care system, people under age 65 are at risk of losing and regaining health insurance coverage over their lifetimes, which has important consequences for their physical and mental health. Despite the importance of insurance stability, we have an incomplete understanding about the complex factors influencing whether people lose and regain coverage. To advance our understanding of the dynamics of health insurance coverage and guide future research, our purpose is to present a new conceptual model of health insurance stability, where instability is defined as a person's loss or change of coverage, which can occur more than once in a lifetime. Drawing from theory and evidence in the literature, we posit that personal and plan characteristics, the health system, and the environmental context – economic, social/cultural, political/judicial, and geographic – drive health insurance stability over the life course and are understudied. Studies are needed to identify the populations most at risk of experiencing insurance instability and vulnerability in health outcomes that results from such insecurity, which may suggest reforms and health policies at the individual, health system, or environment levels to reduce those risks.
      pubtype: Academic Journal
      doctype:
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N