The fifth volume in a series reviewing published literature and documenting conceptualization and construction of health status measures used in the Health Insurance Study (HIS). Analyses reported are based on non-HIS sources; plans for analyzing HIS data from the Health Perceptions Questionnaire (HPQ) are documented. The HPQ contains six summated ratings scales reflecting perceptions of current, past, and future health, resistance-susceptibility, sickness orientation, and health worry/concern. These measures appear sufficiently reliable and valid for testing hypotheses on effects of differences in coinsurance and deductibles and fee-for-service compared with group practice and of differences in use of medical care services on health status in general populations.

Fourth in a series on Health Insurance Study (HIS) measures, this volume reviews published literature and documents the conceptualization and construction of social health measures. The literature review indicated that social health had been measured in terms of quantity and quality of interpersonal interactions and extent of community participation. Scaling issues were rarely addressed and there was little agreement on how to aggregate data to construct a social health index. Reported reliability estimates were moderate to high. Associations among different definitions of social health were weak, as were those between social health and other health and health-related constructs. The HIS social health battery focuses on objective social health constructs in the community, family, and social role areas. Plans for analyzing social health data (which were not available when this volume was written) and constructing HIS measures are discussed.

This report presents the results from empirical tests of strategies for scoring social well-being items fielded by RAND's Health Insurance Experiment (HIE). Section II presents background material, a conceptual framework for social well-being measurements, an outline of measurement issues and strategies involved in quantifying questionnaire responses, and a summary of how other investigators have constructed social well-being measures. Section III describes the methodology used in the HIE. Sections IV and V present results of empirical analyses, recommend a scoring rule for each of the 11 HIE social well-being items, and describe the results of scaling analyses including descriptive statistics, interrelationships among measures, the reliability of resulting scores, associations between social well-being measures and selected sociodemographic and health variables, and effects of socially desirable responding on social well-being measures. Section VI discusses the findings and offers suggestions for future research based on the experiences with HIE measures.

A study of consumer knowledgeability about medical care services and its effect on the role consumers might play in decisions affecting resource allocation, especially whether competition and/or cost-sharing strategies should be pursued or whether regulatory strategies are more promising. An important goal of the study was to derive a scale that would permit measurement of the extent of consumer knowledge. Analyses of a ten-item questionnaire administered to nonaged persons showed that consumers are knowledgeable about some areas of medical care and uninformed about others. If a procompetitive medical care strategy is pursued, consumers need to be educated about board certification, staff privileges, and other factors pertinent to choosing a regular source of medical care. Factor analyses indicated that a substantial amount of information from item responses can be summarized in a multi-item scale that is reliable and valid as a measurement of patient sophistication.