Health insurance and crowdfunding: Research sample and methodology

Methods

Sample

Donation-based crowdfunding platforms are screened in Germany, the most highly populated country in Europe [69]. On the one hand, the more populated a country is, the higher the chance that individuals search for financing of additional health needs. On the other hand, Germany has a universal healthcare system, the target system of this research. As argued before, the vast majority of residents are enrolled in mandatory state health insurance, which covers a wide array of health care services. Nevertheless, some medical costs are not covered (e.g., patient co-payments, several alternative and complementary therapies, medical interventions with a low expected success rate, experimental therapies) which might motivate individuals to turn to crowdfunding.

In Germany, as of May 2018, three large donation-based crowdfunding platforms offered individuals the opportunity to launch crowdfunding campaigns to cover their medical expenses: Leetchi, Betterplace, and Gynny [70]. On Leetchi, as of 4 May 2018, the time of screening crowdfunding platforms for eligibility, 560 projects were listed in the category of Medicine (Medizin) [71]. On Betterplace 629 crowdfunding campaigns were launched in the category of Health (Gesundheit) in Europe [72]. As compared to Leetchi, Betterplace maintains a strong focus on campaigns launched by non-profit organizations, such as municipalities, hospitals, and foundations; the number of crowdfunding campaigns launched by individuals was rather exceptional. On Gynny 2372 projects were listed covering a wide array of categories [73]. Although Gynny is listed as a crowdfunding platform on Crowdfunding.de, the platform is designed very differently from typical donation-based crowdfunding platforms. On Gynny individuals can donate through online shopping at partner shops without paying extra charges; they simply need to insert the code of the crowdfunding campaign they wish to support. In this research, crowdfunding campaigns were downloaded from Leetchi; typically, individuals launch campaigns there and its design is similar to many other donation-based crowdfunding platforms.

From the 560 campaigns listed on Leetchi in the category of medicine [71] we excluded those which were unrelated to health. The excluded campaigns were identified through text mining. We built a vocabulary of 505 health-related German words; the vocabulary included words such as diagnose, sick, medicine, medication, doctor, therapy, pain, cancer, treatment, cure, care, and operation and all related compound words. From the 560 crowdfunding campaigns, 164 did not meet this inclusion criterion; the text of these campaigns did not include any of the 505 health-related words defined in the vocabulary.

In addition, from campaigns containing at least one word from the vocabulary, the following were excluded: 1) duplicates; 2) campaigns written in a language other than German; 3) campaigns without any text; 4) campaigns covering non-health related needs of refugees, the homeless or hungry; 5) campaigns involving medical care for animals. Campaigns entitled “Illness of Kunz Walter” or “Medical help” are typical examples of campaigns excluded due to empty campaign descriptions [74, 75]. The campaign entitled “Humanitarian aid for refugees in Europe” is a prototype of a campaign excluded due to non-health related needs [76]. As a result of these additional exclusion criteria, 16 crowdfunding campaigns were excluded. The final sample thus included 380 crowdfunding campaigns.