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SHARElife – Healthcare Module (English Version)

General Information:

*Note: This item was tested in German. This is an English translation of the original German wording. The translation does not correspond exactly to the wording in the English SHARE source questionnaire.*

Question Text:

Have you ever needed a medical treatment or to see a doctor but you did not because the costs were too high?
[Haben Sie jemals auf einen Arztbesuch oder eine Behandlung verzichtet, weil es Sie zu viel gekostet hätte?]
In conclusion, all ten respondents were asked if they saw any difference between two wording versions, i.e. ‘Have you ever given up a medical consultation or medical treatment because it would have cost you too much?’ and ‘Have you ever given up a medical consultation or medical treatment because you could not afford it?’ Four respondents (01, 03, 05 and 10) did not mention any difference between the two wording versions whereas the remaining six respondents did notice a difference: respondents 02 and 04 said that ‘being able to afford’ referred to a subjective situation whereas ‘costs were too high’ concerned the price and, therefore, it was a neutral indication:
  • ‘Not being able to afford something, that’s my case. The costs being too high refers to those who set the price.’ (respondent 02)
  • ‘Being able to afford something refers to my own financial situation. It does not necessarily refer to the objective price.’ (respondent 04)
Respondents 06 and 07 claimed that one is still able to afford a treatment in spite of high costs:
  • ‘But if it costs too much but is essential for me, I want to afford it.’ (respondent 06)
  • ‘Someone must check and say, that costs too much but I wait to have the treatment whenever it becomes possible.’ And someone else would say, I can afford it. Let’s have the treatment right now.’ (respondent 07)
Respondents 08 and 09 refer to the difference between a situation when someone gives up a treatment not because they are not able to afford it but, rather, because the costs are not refunded (‘I am able to afford it but still don’t do it because no one reimburses it.’ respondent 08) A further reason is when a treatment is not considered essential (‘If I see an extra medical service as essential or sensible, then I am willing to pay a certain amount.’ respondent 09).

Answer Categories:

Yes [Ja]
No [Nein]

Recommendations:

In order to a situation where the respondents would only think of recent treatments, we recommend mentioning that the respondents should also consider situations from their youth, and not only from their adult lives.
Considering both tested wording versions, we recommend sticking with the original verbalisation ‘because it would have cost you too much.’ The alternative wording ‘not being able to afford it’ tends to be influenced by the thoughts of one’s own financial situation whereas the version ‘because it would have cost you too much’ concentrates more strongly on the costs and price of the treatment itself.
"When answering the following questions, please consider not only your adult life but also your childhood and youth. Have you ever needed to see a doctor but you did not because the costs were too high?
[Bitte denken Sie bei der Beantwortung der folgenden Fragen nicht nur an Ihr Erwachsenenleben, sondern auch an Ihre Kindheit und Jugend. Haben Sie jemals auf einen Arztbesuch oder eine Behandlung verzichtet, weil es Sie zu viel gekostet hätte?]"
Furthermore, we recommend that question 1 and 2 should explicitly state that the respondents should not include dentist appointments or dental treatments in their answers.