Cross-Sectional Evaluation of Health Insurance Knowledge and Self-Efficacy in Adolescents and Young Adults with Inflammatory Bowel Disease.

Objective: To evaluate the status of health insurance knowledge and self-efficacy among adolescents and young adults with inflammatory bowel disease (AYA-IBD).

Study Design: English-proficient AYA-IBD ≥15 years receiving care at an academic pediatric practice were invited to perform the Kaiser Family Foundation survey on health information knowledge and the Health Insurance Literacy Measure. Analyses of responses by demographic factors were performed using nonparametric analyses and agreement analyses were performed to compare survey responses.

Results: Fifty AYA-IBD (60% 15-17 years old; 54% male; 76% White; 32% Hispanic) completed the surveys. Most AYA-IBD (58%) answered less than half the health insurance knowledge questions correctly. Reported ability and confidence in choosing and using health insurance was slight to moderate (median 2.8 on Likert scale of 1 [not at all confident] to 4 [very confident]). While health insurance knowledge scores did not vary by demographic factors, total health insurance self-efficacy increased with disease duration, and Hispanic participants reported reduced ability to select health insurance than non-Hispanic counterparts.

Conclusions: AYA-IBD demonstrated suboptimal health insurance knowledge and self-efficacy. Our findings identify an important opportunity to provide health insurance education to help prepare all AYA-IBD to manage the costs of medical care during the transition process to adulthood.