Faculty of Health Sciences and Medicine and Center for Health, Policy and Economics, University of Lucerne, Alpenquai 4, Lucerne, 6005 Switzerland.
Eur J Public Health. 2024 Apr 3;34(2):237-243. doi: 10.1093/eurpub/ckad190.
Health insurance literacy (HIL) is crucial for individuals to make informed-decisions and navigate complex choice-based health insurance systems. However, there is a lack of evidence on HIL in countries outside the US, with Switzerland no exception.
Using the HILM-CH, a survey instrument developed to measure HIL in Switzerland, this study first describes the answers to the HILM-CH. Second, the study uses ordinary least squares and quantile regressions to investigate the associations between the HIL score and demographic, socioeconomic, health, and preference factors in the German, French, and Italian Swiss regions.
A third of the population faces difficulties in finding health insurance information. Understanding it and managing the financial aspects of the Swiss health insurance system pose the biggest barriers to the population. The HIL score significantly and positively correlates with age and financial risk, while non-Swiss individuals have lower HIL scores. No association was found between HIL, gender, education and time preference. There is a small health gradient, with more doctor visits associated with higher HIL in the lowest quantiles of the HIL score. Similarly, wealthier individuals in the Swiss German part of Switzerland have a higher HIL when choosing their health insurance.
This study provides important insights into Swiss HIL and its associated factors. These findings contribute to the international literature on HIL and highlight the importance of understanding variations in HIL and various factors in choice-based health insurance systems.
健康保险素养（HIL）对于个人做出明智决策和驾驭复杂的基于选择的健康保险系统至关重要。然而，除美国以外的国家（包括瑞士）在 HIL 方面的证据有限。
本研究使用瑞士开发的 HILM-CH 调查工具，首先描述 HILM-CH 的答案。其次，研究使用普通最小二乘法和分位数回归，调查德国、法语区和意大利语区 HIL 得分与人口统计学、社会经济、健康和偏好因素之间的关联。
三分之一的人口在寻找健康保险信息方面存在困难。理解健康保险和管理瑞士健康保险系统的财务方面对民众构成最大障碍。HIL 得分与年龄和财务风险呈显著正相关，而非瑞士人 HIL 得分较低。HIL 与性别、教育和时间偏好之间没有关联。存在一个小的健康梯度，在 HIL 得分最低的几个百分位数中，就诊次数越多，HIL 得分越高。同样，在瑞士德语区，财富较多的个人在选择健康保险时 HIL 得分更高。
本研究提供了有关瑞士 HIL 及其相关因素的重要见解。这些发现为 HIL 的国际文献做出了贡献，并强调了理解基于选择的健康保险系统中 HIL 差异和各种因素的重要性。
