to Pretest Database Pretest Database
Project Title:SHARElife – Healthcare Module (English Version)
  1. 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.*
  2. Question Text
    (Findings/Recommendations): 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?]
  3. Answer Categories Yes [Ja]

    No [Nein]


    1. 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.
  1. Cognitive Techniques:Information image/link to cognitive pretesting General Probing, Specific Probing, Emergent Probing.
  2. Findings for Question: Five out of the ten respondents stated that they did have a situation where they needed to see a doctor or undergo a treatment but did not because it would have cost too much (respondents 01, 03, 05, 09 and 10). The remaining five respondents answered this question with a ‘No’ (respondents 02, 04, 06, 07 and 08).

    Probing questions were used with the intention to identify what kind of treatments and types of costs the respondents had in mind. A further aim was to find out at which level of expenses the respondents abandoned a medical consultation because ‘it would have cost you too much.’ As a result, the respondents who had ever needed to see a doctor or undergo a treatment but did not because they could not afford it were asked about the reason for their answer. Furthermore, they were asked about the kind of treatment involved and how high the expenses for that treatment would have been.

    One respondent (01) mentions a bone treatment where the cost was 60 Euros: ‘I was supposed to have a certain bone test (…) and it would’ve cost 60 Euros, and I simply couldn’t do it with my pension. As a result, I gave it up.’ Respondent 01 renounced another treatment involving some infusions after an acute hearing loss, which was supposed to cost 250 to 300 Euros (‘I cannot afford it but, thank God, pills helped to heal it.’).

    Respondent 03 was prescribed two pairs of insoles. The private costs were 39 Euros for each pair. The respondent bought only one pair: ‘The doctor prescribed two pairs of insoles. And then I said, no, I cannot afford two pairs at this point. (…) Then, I only bought one pair.’.

    Respondent 05 did not see a doctor for several orthopaedic treatments (costs: 300 Euros) because not enough money was available. Respondent 09 gave up a prostate treatment (costs: 24 Euros) because the treatment did not seem necessary. Respondent 10 did not see a doctor for a preventive medical check up related to an eye cataract, which was supposed to cost 20 Euros.

    Respondents 09 and 10 rated the treatments they gave up and did not see a doctor as ‘not very important’. Respondents 01, 03 and 05 considered those treatments as ‘very important’.

    Respondents 01, 09 and 10 explained that the treatments were not supposed to be paid from their health insurance. Respondents 03 and 05 claimed that certain additional private payments were too high.

    All the respondents who answered ‘No’ in question 1 were asked if they ‘had ever given up a visit to a doctor/ a treatment’ or if they ‘had been able to afford all treatments so far.’ All the respondents said that treatments had always been affordable for them (respondents 02, 04, 06, 07 and 08).

    Respondents 06, 07 and 08 explained that there were no treatments which are not paid from their health insurance. Only respondents 01 and 04 mentioned treatments which were not financially covered by their health insurance: For example, ‘Having a blood test and having a blood sample taken’ (respondent 02) or ‘Shots as part of cancer aftercare’ (respondent 08). Respondent 08 stated additionally that she had once opted for cheaper medical service due to high expenses (generic medication for blood pressure). This did not apply to the respondents 02, 04, 06 or 07.

    Respondents 07 and 08 stated they had private health insurance and, therefore, did not (have to) give up any treatments or consultations.
  1. Question Topic: Public health/ Visits to the doctor & treatments
  2. Construct: Abandonment of medical service due to high costs