Insurance Barriers, Gendering, and Access: Interviews with Central North Carolinian Women About Their Health Care Experiences

Summary & key facts

This small qualitative study used 14 interviews (11 women health consumers and 3 women practitioners) in central North Carolina to learn about women’s experiences getting health care. Women described scheduling problems, insurance and cost barriers, and negative or dismissive in-person encounters. Many participants said there were not enough postpartum resources. The authors conclude these problems appear even for insured women and may come from system-level rules and organizational culture. They suggest improving access to affordable postpartum care, making scheduling and care coordination easier, and studying women’s in-person care experiences more closely.

Key facts:

• The study conducted 14 semistructured interviews: 11 women who use health care and 3 women practitioners.
• All 11 women participants had health insurance; insurance types included Blue Cross Blue Shield, United HealthCare, Tricare, Aetna, and 2 had Medicaid or pregnancy Medicaid.
• Participants’ average age was 34 years (range 25–52).
• Seven of the 11 women had a master’s degree or higher; the other 4 had a bachelor’s degree.
• About 63% of the women reported having a regular care practitioner.
• About 45% of the women interviewed had been pregnant and are mothers.
• Common barriers reported were trouble scheduling appointments, insurance- or cost-related barriers, and dismissive or negative in-person encounters with clinicians.
• Participants frequently reported a lack of resources and access to care after giving birth (postpartum care).
• Practitioners interviewed noted themes including lack of knowledge about women’s disease burden, overmedicalization of women’s care, and gaps in postpartum care.
• The authors recommend 3 areas for future work: increase awareness of and access to affordable postpartum care; reduce burdens around scheduling and improve care coordination; and do more research on women’s experiences during in-person heal

Abstract

Future clinical and research efforts should include 1) increasing awareness of and facilitating access to affordable postpartum care, 2) easing burdens around scheduling appointments and improved care coordination, and 3) more research exploring women's experiences during in-person health care encounters. Concerns and barriers that women described may be due to systems-level requirements and constraints.

Topics

Diversity and Career in Medicine Primary Care and Health Outcomes Sex and Gender in Healthcare

Categories

General Health Professions Health Professions Health Sciences

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Economic growth Economics Family medicine Health care Medicine Nursing

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Anxiety Depression Anxiety or worry Sadness or low mood