Conceptualization and Measurement of Health for Adults in the Health Insurance Study

Vol. II, Physical Health in Terms of Functioning

by Anita Stewart, John E. Ware, Robert H. Brook, Allyson Ross Davies

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The second volume in a series reviewing published literature and documenting conceptualization and construction of health status measures used in the Health Insurance Study (HIS). The HIS fields two physical health batteries. Scaling studies supported construction of one single-item (self-care) and three cumulative scale measures (physical, mobility, and role activities) and an aggregate indicator from the Functional Limitations battery. Three summated ratings scales (basic, moderate, and overall) were constructed from the Physical Abilities battery. HIS physical health measures appear sufficiently reliable and valid for testing hypotheses on effects of differences in coinsurance and deductibles and fee-for-service compared with prepaid group practice and of differences in use of medical care services on physical health status in general populations. Investigators using HIS measures may choose among several options, depending on their study's purpose, physical activities of interest, and tradeoffs in reliability, validity, and precision.

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