Health Policy

Who provides open‐ended comments? Assessing item nonresponse bias in Medicaid surveys of members and dentists

Reynolds, J.C.; McKernan, S.C.; Sukalski, J.M.C.



This aim of this study was to examine factors associated with survey item nonresponse to open‐ended items in mailed surveys.


Data sources include two surveys conducted in Iowa in 2016 – one to a random sample of Medicaid dental program members and one to private practice dentists. Item nonresponse bias for open‐ended comments was examined by comparing differences between commenters and noncommenters. Bivariate and logistic regression analyses examined differences based on demographic characteristics, attitudes, and experiences with the program, and survey mode.


Among members, respondents who were Black, older, unemployed, had a recent dental visit, rated the plan poorly, and completed the survey on paper were significantly more likely to provide comment. Among dentists, those who participated in the plan and those who completed the survey online were significantly more likely to provide comment.


Members and dentists with direct experiences with the Medicaid dental program were more likely to provide open‐ended survey comments, whereas we found inconsistent results between members and dentists with regard to the impact of demographic characteristics, survey mode, and attitude toward the plan.