Validity of self-reported health plan information in a population-based health survey.
OBJECTIVE
To validate information on private health insurance coverage in a population-based study.


METHODS
Respondents to the Massachusetts Behavioral Risk Factor Surveillance System were asked the name of their health plan company (affiliation) and specific brand of insurance (product), the duration in which they belonged to the plan, and demographic and health-related data. Information on plan affiliation and product was used to classify individuals on type of coverage. At the end of the survey, respondents with health insurance were asked to retrieve their health plan cards, and to read detailed information from the cards. Self-reported data were compared with information from the cards.


RESULTS
Self-reported information on health plan affiliation agreed with plan cards for 93 percent of individuals, while agreement was 79 percent for health plan product. Among health maintenance organization (HMO) participants, 93 percent correctly reported being in an HMO (sensitivity), whereas 76 percent of respondents in a non-HMO plan correctly self-reported (specificity). Individuals with higher levels of income, those with a primary care doctor, and those in a health plan for at least 1 year had higher agreement. Higher validity was associated with poor physical health and recent cancer screening.


CONCLUSIONS
Self-reported data on health plan affiliation and product have good validity in a population-based sample of adults. While agreement differs according to specific respondent characteristics, these differences do not appear substantial.
Mucci
Lorelei A
LA
Department of Epidemiology, Harvard School of Public Health and Channing Laboratory, Harvard Medical School/Brigham and Women's Hospital, Boston, Massachusetts, USA.
Wood
Phil A
PA
Cohen
Bruce
B
Clements
Karen M
KM
Brawarsky
Phyllis
P
Brooks
Daniel R
DR
D000293:Adolescent; D000328:Adult; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D017149:Private Sector; D015203:Reproducibility of Results; D012959:Socioeconomic Factors