Several major national surveys employ a similar battery of questions to measure health insurance coverage. In spite of the common usage of this series, there seems to be little evidence from qualitative questionnaire design literature that the series is well-understood by respondents. Furthermore, some recent quantitative evidence casts some doubt on the validity of the series; it seems to result in a fairly accurate measure of whether an individual is insured or not, but insured respondents may not correctly report the particular type of insurance they have. Specifically, it appears that public insurance is under-reported and private coverage is over-reported. Due in part to these findings, and guided by evidence from cognitive testing, the series was redesigned and cognitively tested in late 2000. The major difference between the standard and redesigned series is in the flow of the questions. In the standard series, respondents are asked eight separate questions -- each asking about coverage under a specific type of health insurance (e.g.: employer-sponsored, Medicaid, etc.). The redesign, by contrast, employs a "funneling" technique, where the series of questions go from general to specific. First, respondents are asked whether or not they are covered. Among those covered, the general source of insurance (employer, government, etc.) is established, followed by more refined questions on the coverage (e.g.: for employer-based insurance, policyholders and dependents are identified). This presentation will examine both the qualitative and quantitative evidence on the standard battery questions, and present qualitative findings from the cognitive testing of the redesigned series.
Learning Objectives: Participants will be able to identify some of the limitations of the standard set of questions used to measure health insurance in many major national surveys, assess qualitative findings on an alternative methodology and apply these results to his/her own research.
Keywords: Health Insurance, Methodology
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.