Nguyen Ha Trong, Le Huong Thu, Connelly Luke, Mitrou Francis
Telethon Kids Institute, Perth, Western Australia, Australia.
The University of Western Australia, Perth, Western Australia, Australia.
Health Econ. 2023 Dec;32(12):2709-2729. doi: 10.1002/hec.4748. Epub 2023 Aug 5.
Studies on health insurance coverage often rely on measures self-reported by respondents, but the accuracy of such measures has not been thoroughly validated. This paper is the first to use linked Australian National Health Survey and administrative population tax data to explore the accuracy of self-reported private health insurance (PHI) coverage in survey data. We find that 11.86% of individuals misreport their PHI coverage status, with 11.57% of true PHI holders reporting that they are uninsured and 12.37% of true non-insured persons self-identifying as insured. Our results show reporting errors are systematically correlated with individual and household characteristics. Our evidence on the determinants of errors is supportive of common reasons for misreporting. We directly investigate biases in the determinants of PHI enrollment using survey data. We find that, as compared to administrative data, survey data depict a quantitatively different picture of PHI enrollment determinants, especially those capturing age, gender, language proficiency, labor force status, disability status, number of children in the household, or household income. We also show that PHI coverage misreporting is subsequently associated with misreporting of reasons for purchasing PHI, type of cover and length of cover.
关于医疗保险覆盖范围的研究通常依赖于受访者自我报告的指标,但这些指标的准确性尚未得到充分验证。本文首次利用澳大利亚全国健康调查与行政人口税收数据的关联,来探究调查数据中自我报告的私人医疗保险(PHI)覆盖范围的准确性。我们发现,11.86%的个体误报了他们的PHI覆盖状态,其中11.57%的真正PHI持有者报告自己未参保,而12.37%的真正未参保者自认为已参保。我们的结果表明,报告误差与个人及家庭特征存在系统性关联。我们关于误差决定因素的证据支持了误报的常见原因。我们使用调查数据直接研究了PHI参保决定因素中的偏差。我们发现,与行政数据相比,调查数据描绘的PHI参保决定因素的情况在数量上有所不同,尤其是那些反映年龄、性别、语言能力、劳动力状况、残疾状况、家庭子女数量或家庭收入的因素。我们还表明,PHI覆盖范围的误报随后与购买PHI的原因、保险类型和保险期限的误报有关。