The impact of insurance coverage on consumer utilization of health services: An exploratory study

Abstract

Purpose

The purpose of this paper is to identify how need for service, enabling factors and pre-disposing characteristics influences access to service. In addition, the authors seek to examine the moderating influence of pre-disposing variables on the relationship between insurance and health services utilization.

Design/methodology/approach

The authors utilize data from a major metropolitan hospital in the USA to test and extend the behavioral model of health care.

Findings

Results indicate that insurance and pre-disposing variables have a direct impact on type of health service utilization. However, the insurance effect is found to vary by demographic factors.

Research limitations/implications

This paper is limited to secondary data. Future work can incorporate both attitudinal and behavioral measures to obtain a more comprehensive evaluation of services access.

Practical implications

The research offers a tactical framework for management to segment consumer markets more effectively.

Social implications

Through the framework, management will have the requisite knowledge to target segmented populations based on need, insurance, and pre-disposing variables which will help improve access to services and clinical outcome.

Originality/value

The findings of this paper will serve as a basis for future research exploring the influence of insurance on access to services.

Citation

O'Connor, G.E. (2015), "The impact of insurance coverage on consumer utilization of health services: An exploratory study", International Journal of Bank Marketing, Vol. 33 No. 3, pp. 276-297. https://doi.org/10.1108/IJBM-05-2014-0061