Abstract
Abstract Background Health insurance literacy (HIL), defined as the ability to seek, obtain, understand health insurance, and use it once enrolled, is a concept that has only recently started to gain increasing attention. HIL is likely to influence individual’s usage of health care services and subsequent outcomes. Yet, little is known about its distribution and its associations with health(-related) outcomes, due to the fragmented nature of the field and assessment tools. The objectives of this study are to (1) summarize information on current assessment tools for HIL and related constructs, (2) describe conceptual dimensions assessed, and (3) describe psychometric properties of found tools. Methods A systematic literature review was performed using various databases (e.g. PubMed, CINAHL, Econlit), identifying literature that provided a description of tools assessing HIL and related constructs (e.g. health insurance knowledge). In the following, two independent reviewers will screen abstracts and studies included for full-evaluation. The COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) will be used to assess quality of included studies and measures. Results Information on found tools will be summarized, including information on type of measure (e.g. objective or self-reported assessment), items and scales, scoring, target population, assessed domains, correlation with other measures. Preliminary results show large variations across tools that have been used to assess HIL and related constructs, with the majority not being rigorously validated. Conclusions The resulting summary of this study is intended to work as a basis for the conceptualization of HIL and development and validation of assessment tools, with the aim to homogenize and improve research in the field of HIL. Key messages Current knowledge on HIL distribution and its association with health(-related) outcomes is fragmented due to lack of consistency on HIL conceptualization and assessment. This systematic literature review aims to summarize information on current HIL assessment tools to inform the development and validation of HIL assessment tools.
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