highly significantp < 0 . 001
All factor loadings are highly significant and substantively large (e.g., Health Insurance Satisfaction → Perceived Coverage Quality: λ = 1 . 383 , z = 12 . 388 , p < 0 . 001 ; Cost-Driven Care Avoidance → Health Access Cost Experience: λ = 1 . 073 , z = 11 . 984 , p < 0 . 001 ), confirming reliable measurement of the latent dimensions.