Knowledge of Health Care Benefits Among Patients With Depression

OBJECTIVE: To evaluate the accuracy of patient self-reports of health care insurance coverage relative to actual health care benefits and to explore patient predictors of accuracy among patients with depression. METHODS: Data were analyzed from 767 patients with current depressive symptoms and disorder who completed a self-report mail survey that included questions about health insurance and for whom we also obtained actual health care benefits records. Percentage agreement and kappa statistics were calculated for different types of benefits (medical visit, pharmacy and mental health visit copays, and mental health visit limits), and we used multivariate analysis to examine predictors of accuracy. RESULTS: Accuracy of self-reports relative to administrative data were good for measures of medical visits and prescription copays (kappa = 0.79 and 0.64), but less accurate for measures of mental health benefits (kappa = 0.19 for copays and 0.40 for visit coverage). Recent use of health care services (past 6 months) increased the accuracy of medical benefits but not of mental health benefits. Inaccuracy of mental health benefits was in the direction of patients perceiving more generous coverage than was actually available to them. Men and those with greater wealth were more knowledgeable about their medical benefits. Those from a nonminority ethnic group, who were less satisfied, and were less sick had better knowledge about their mental health benefits. CONCLUSIONS: Agreement between self-reports and actual benefits was stronger for general medical services than for mental health care. Background, experience, and sickness lead to more accurate recall of insurance information

Depression (economics) · Family medicine · Health care · Medical prescription · MEDLINE · Mental health · Psychiatry · Medicine · Mental Health Treatment and Access · Nursing · Patient Satisfaction in Healthcare · Pharmacy · Primary Care and Health Outcomes

• A conceptually based approach to understanding chronically ill patients’ responses to medication cost pressures

  Open Access•John D Piette, Michele Heisler et al.•Social Science & Medicine•2006

  Incluir item

• Cost-Sharing

  John Hsu, Mary Reed et al.•Medical Care•2004

  Incluir item

• Racial and Ethnic Differences in Wealth in the Health and Retirement Study

  James P Smith•The Journal of Human Resources•1995

  Incluir item

• The Health Belief Model

  Open Access•Lois A Maiman, Marshall H Becker•Health Education Monographs•1974

  Incluir item

• Validation of self-reported chronic conditions and health services in a managed care population11The full text of this article is available at http

  Open Access•Linda Martin, Linda M Martin et al.•American Journal of Preventive…•2000

  Incluir item

• Historical Origins of the Health Belief Model

  Open Access•Irwin M Rosenstock•Health Education Monographs•1974

  Incluir item

• The Measurement of Observer Agreement for Categorical Data

  J R Landis, Gary G Koch•Biometrics•1977

  Incluir item

• The Effect of a Medicaid Drug Copayment Program on the Utilization and Cost of Prescription Services

  Arthur A Nelson, C Eugene Reeder et al.•Medical Care•1984

  Incluir item

• Are Better Ratings of the Patient-Provider Relationship Associated With Higher Quality Care for Depression

  Lisa S Meredith, Maria Orlando et al.•Medical Care•2001

  Incluir item

• Agreement Between Administrative Files and Written Medical Records

  T MICHAEL KASHNER•Medical Care•1998

  Incluir item

• The Effect of Office Visit Copayments on Utilization in a Health Maintenance Organization

  Daniel C Cherkin, Louis Grothaus et al.•Medical Care•1989

  Incluir item

• Is magnitude of co-payment effect related to income? Using census data for health services research

  Open Access•Daniel C Cherkin, Louis Grothaus et al.•Social Science & Medicine•1992

  Incluir item