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: Have you ever postponed a dentist’s visit to help you keep your living costs down?
    [Haben Sie jemals Zahnarztbesuche aufgeschoben, weil Sie sparen mussten?]
  3. Answer Categories Yes [Ja]

    No [Nein]

    1. Recommendations: In general, it can be concluded that the respondents actually think of acute and urgent treatments rather than only about the recommended annual preventive medical check ups. However, the recalled time period was mostly related to one specific postponed treatment. In consequence, we recommend reformulating the question in order to emphasize that the respondents are supposed to think of all dental treatments they have ever postponed.
      "Have you ever postponed a dentist’s visit because it was too expensive? Please try to remember all dentist visits.
      [Haben Sie jemals Zahnarztbesuche aufgeschoben, weil diese zu teuer waren? Bitte versuchen Sie wieder sich an alle Zahnarztbesuche zu erinnern.]"
  1. Cognitive Techniques:Information image/link to cognitive pretesting General Probing, Specific Probing, Emergent Probing.
  2. Findings for Question: Seven out of ten respondents (respondents 02, 03, 04, 06, 07, 08 and 09) choose ‘No’ in this question. The remaining three respondents (respondents 01, 05 and 10) stated that they had had a situation where they postponed a dentist visit because they had to save money. Respondent 04 said that he had postponed a treatment a few times for about a month because the costs would have been refunded by his additional dental insurance at a later point in time: ‘For tactical reasons,’. Consequently, respondent 04 did not postpone his treatments because he had to save money but because he wanted to make sure that the expenses would be refunded by his insurance. The treatments he mentioned included mainly dental prostheses, bridges, implants or tooth crowns: ‘I had a tooth extracted and now my bridge is too small and I needed a new one but I cannot afford it because it’s too expensive,’ (respondent 01). None of the respondents who answered this question with a ‘Yes’ considered their annual recommended preventive medical check up but, instead, they thought of acute and urgent problems.

    All the respondents who answered this question with a ‘Yes’ were also asked about the costs of treatments that they had in mind. Respondent 01 mentioned expenses between 300 and 400 Euros for a bridge for which there was no cheaper alternative. Respondent 05 mentioned costs of more than 1000 Euros for a dental prosthesis for which there was also no cheaper alternative. Respondent 10 talked about approximately 2000 Euros for a dental prosthesis. The last of those respondents said that an alternative material would have influenced the costs but he would not have the treatment anyway: ‘(…) the only difference is in the material. No, if it cost 1500 Euros instead, I wouldn’t have had that anyway.’ (respondent 10).

    In general, all the respondents who stated that they had had a situation that they postponed a dentist appointment because of costs only reported one treatment. Following some further questions from the interviewer, respondent 10 mentioned another treatment. Apart from the dental prosthesis he had already mentioned, he talked about a bridge replacement. However, he had never seriously considered that procedure because he had his wisdom teeth removed instead and that solved the problem.

    Additionally, the respondents were asked if they had had additional dental insurance in order to find out if potential treatments were covered by such insurance.
    • Three respondents (respondents 04, 06 and 08) had bought additional dental insurance which either covered the costs of a treatment or would probably cover them: ‘I have never had to pay an additional private fee,’ (respondent 08).
    • Two respondents (respondents 01 and 02) had bought additional dental insurance which did not cover either specific or all treatments:‘It doesn’t cover everything. It only refunds the part that I have to pay, the half“ (respondent 02).
    • Five respondents (respondents 03, 05, 07, 09 and 10) do not have any additional dental insurance.
    Consequently, respondent 01 postponed a dental treatment although he had additional dental insurance because the insurance did not cover the treatment either partly or at all. Respondent 04 postponed certain treatments despite having an additional dental insurance and did so for a strategic reason, i.e. because his insurance would cover the costs at a later time.

    Those respondents (respondents 02, 03, 04, 06, 07, 08 and 09) who answered question 5 with a ‘No’ were asked if they had ever postponed a dental treatment due to a different reason. Only respondent 08 answered ‘Yes’ here and explained it as follows: ‘Because I was not convinced that the suggestion made by my dentist was urgent,’ (respondent 08). Respondent 04 was the only one to admit that he had decided to go for cheaper dental procedure because of financial reasons.

    Respondent 10 suggested that it would have been easier to identify the time periods if the question contained a list of all treatments ever postponed. Question 6 could have been answered more easily with the aid of such a list.
  1. Question Topic: Public health/ Visits to the doctor & treatments
  2. Construct: Postponing dental service due to keeping living costs down