Psychometric Evaluation of a 10-Item Health Insurance Knowledge Scale

Background: College students are a priority population for health insurance literacy interventions. Yet, there are few psychometric studies on measuring health insurance knowledge – a core construct of health insurance literacy. Methods: We administered a health insurance survey to 2,250 college students. We applied Classical Test Theory and Item Response Theory methods to estimate psychometric properties of the Kaiser Family Foundation's 10-item health insurance knowledge quiz. Results: The scale is unidimensional, and a two-parameter logistic model best fit the data. IRT estimates indicated varying item discriminations (a range: 0.717–2.578) and difficulties (b range: −0.913–1.790). Precision of measurement was maximized for students half a standard deviation below the mean (θ = −0.686) health insurance knowledge ability. Conclusions: This scale can be used to identify gaps in health insurance knowledge among college students and be applied in clinical and community health education practice.