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Changes in health insurance and concomitant changes in quality of life in patients receiving long-term home parenteral nutrition care were explored. A decrease in quality of life and increase in depression were significantly associated with a change of insurance providers. Knowing the importance of health insurance as a family economic resource, nurses working in these settings may be alert for potential socio-emotional problems when health insurance providers change or coverage is less. Policymakers also have an opportunity to ease the financial burden of long-term disease management by expanding coverage for prescription drugs in Medicare benefits. [ABSTRACT FROM AUTHOR]