背景:需要医疗服务的个人转向众筹网站,以吸引“人群”或团体寻求经济支持。在过去的十年里,由于几个原因,获得胰岛素的机会大幅减少,包括胰岛素成本的上涨,高免赔额保险计划越来越受欢迎,增加保险费。许多糖尿病患者被迫定量或不服用胰岛素,他们转向众筹网站寻求金融捐赠来购买降低健康风险和死亡率所需的胰岛素,维持生活质量。
目的:本研究旨在探索在美国购买胰岛素的众筹活动请求。
方法:在本回顾性研究中,定量,和定性研究,我们对GoFundMe在线众筹活动和病毒式措施的文本进行了编码(股票,心,和评论)从2019年2月25日至4月15日。我们描述了广告系列(N=205),并使用相关性和定性主题分析探讨了与广告系列成功相关的因素。
结果:大多数运动是由中年人发起的(年龄26-64岁;77/205,37.6%),1型糖尿病患者(94/205,45.9%),以及因保险问题而需要资金的人(125/205,61.0%)。与活动成功相关的因素包括要求≤500美元(P=0.007)和更高的病毒式衡量标准(股票,P=.007;心脏,P<.001;评论,P=.002)。竞选文本中出现了以下4个主题:(1)自我管理和生存的愿望,(2)糖尿病管理站不住脚,给予胰岛素通路,(3)胰岛素负担不起的后果,(4)众筹的隐私问题。竞选评论都是支持性的(有形的,信息性,和情感)和不支持(质疑竞选活动的必要性,并认为众筹不合适)。
结论:尽管众筹网站被用来支持购买胰岛素,竞选活动只筹集了所需资金的一小部分。因此,GoFundMe运动不是在美国获得胰岛素资金的可靠解决方案。应用定量和定性方法足以分析胰岛素等药物的在线众筹成本。然而,对于糖尿病患者来说,使用在线众筹以外的资源来获取和获得胰岛素是至关重要的,因为成功率低。临床医生应常规评估获取或提供胰岛素的困难,和联邦医疗保健政策应该支持降低胰岛素的成本。
BACKGROUND: Individuals in need of medical care turn to
crowdfunding websites to engage a \"crowd\" or group for financial support. In the last decade, access to insulin has decreased considerably for several reasons, including the rising cost of insulin, increasing popularity of high-deductible insurance plans, and increasing insurance premiums. Many people with diabetes are forced to ration or go without insulin, and they turn to crowdfunding websites to seek financial donations to purchase insulin needed to reduce health risks and mortality, and sustain quality of life.
OBJECTIVE: This
study aimed to explore
crowdfunding campaign requests to purchase insulin in the United States.
METHODS: In this retrospective, quantitative, and qualitative
study, we coded the text of GoFundMe online
crowdfunding campaigns and viral measures (shares, hearts, and comments) from February 25 to April 15, 2019. We described campaigns (N=205) and explored the factors associated with campaign success using correlations and qualitative thematic analysis.
RESULTS: The majority of campaigns were initiated by middle-aged adults (age 26-64 years; 77/205, 37.6%), those with type 1 diabetes (94/205, 45.9%), and those needing funds owing to insurance coverage issues (125/205, 61.0%). The factors associated with campaign success included requests for ≤US $500 (P=.007) and higher viral measures (shares, P=.007; hearts, P<.001; comments, P=.002). The following 4 themes emerged from the campaign text: (1) desire for self-management and survival, (2) diabetes management untenable given insulin access, (3) aftermath of insulin unaffordability, and (4) privacy issues with crowdfunding. Campaign comments were both supportive (tangible, informational, and emotional) and unsupportive (questioned the need for the campaign and deemed crowdfunding inappropriate).
CONCLUSIONS: Despite
crowdfunding websites being used to support the purchase of insulin, campaigns raised only a fraction of the money requested. Therefore, GoFundMe campaigns are not a reliable solution to obtain funds for insulin in the United States. Applying quantitative and qualitative methods is adequate to analyze online crowdfunding for costs of medications such as insulin. However, it is critical for people with diabetes to use resources other than online crowdfunding to access and obtain insulin owing to low success rates. Clinicians should routinely assess difficulty accessing or affording insulin, and federal health care policies should support lowering the cost of insulin.