Nivel, The Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
CAPHRI, Maastricht University, Maastricht, The Netherlands.
PLoS One. 2022 Sep 1;17(9):e0273996. doi: 10.1371/journal.pone.0273996. eCollection 2022.
An important criterion for the proper functioning of a managed competition healthcare system, such as operates in the Netherlands, is that all citizens can make well-informed decisions regarding their health insurance policy. In order to achieve this, citizens need certain health insurance literacy skills. It is not known how far citizens in the Netherlands have these skills. The aim of this study is to provide a reliable instrument that measures the health insurance literacy of citizens in the Netherlands. It would be based upon an existing instrument developed in the US. We translated the US Health Insurance Literacy Measure (HILM) into Dutch. Furthermore, we established the psychometric properties of the Dutch version (HILM-NL), and we validated the HILM-NL in a general population sample by sending surveys to members of the Nivel Dutch Health Care Consumer Panel (DHCCP) in February and March 2020. The response rates were respectively 54% (n = 806) and 56% (n = 595). No insurmountable difficulties with equivalence were encountered throughout the translation process. The HILM-NL showed an acceptable level of internal consistency, good test-retest reliability, and a good construct validity. The HILM-NL is a reliable instrument for measuring health insurance literacy among citizens in the Netherlands. With this instrument, it is better possible both to assess how these citizens choose and use a health insurance policy, and also the difficulties they face. It enables citizens in the Netherlands to be supported better in making well-informed decisions on health insurance.
管理竞争型医疗保健系统（如荷兰所采用的系统）正常运行的一个重要标准是，所有公民都能对其健康保险政策做出明智的决策。为了实现这一目标，公民需要具备一定的健康保险素养技能。目前尚不清楚荷兰公民在多大程度上具备这些技能。本研究旨在提供一种可靠的工具，用以衡量荷兰公民的健康保险素养。该工具将基于美国开发的现有工具。我们将美国健康保险素养量表（HILM）翻译成荷兰语。此外，我们还确定了荷兰语版本（HILM-NL）的心理测量学特性，并通过向 2020 年 2 月和 3 月的 Nivel 荷兰医疗保健消费者小组（DHCCP）成员发送调查来验证 HILM-NL 在一般人群样本中的有效性。响应率分别为 54%（n=806）和 56%（n=595）。在整个翻译过程中，我们没有遇到不可逾越的等效性困难。HILM-NL 显示出可接受的内部一致性水平、良好的重测信度和良好的结构有效性。HILM-NL 是一种可靠的工具，可用于衡量荷兰公民的健康保险素养。使用该工具，可以更好地评估这些公民如何选择和使用健康保险政策，以及他们面临的困难。这使荷兰公民能够更好地支持他们在健康保险方面做出明智的决策。
