Sense of medical care policy alienation: conceptualization, scale development, and validation

Although medical care policy affects utilization of medical care resources, most existing research focuses on the impact of effectiveness of medical care insurance coverage on people’s behavior. We argue that psychological distance from medical care policy is important in shaping people’s behavior, leading to a sense of policy alienation from the medical care policy field (SPA-M). We conceptualized SPA-M and developed, validated, and evaluated a scale to assess it. We reviewed the definition of SPA-M and created the item pool for the SPA-M scale with item generation process. Sample I and Sample II included data from 524 to 462 Chinese residents, respectively, without any overlap. We used Sample I to examine the dimensions of the SPA-M scale via exploratory factor analysis. Sample II was used to investigate whether the results of Sample I could be verified through confirmatory factor analysis. The analyses showed that a six-dimension SPA-M model could be confirmed in the two samples. The SPA-M scale has good convergent and discriminant validity, making it potentially applicable in the medical public policy field.