GSB 7.1 Standardlösung

Self-assessed quality of care

In addition to the assessment of the quality of care of chronic diseases on the basis of objective data (e.g. medication or laboratory values), the assessment of the quality of care from the perspective of the person affected is becoming increasingly important and is considered as a significant indicator in the description of the quality of care (Nicolucci et al. 2013). Care that is assessed as good by the affected person is considered to be favourable with regard to better self-management and a lower occurrence of complications. Epidemiological studies on self-assessed quality of care in adults with diabetes are so far hardly available in Germany.

Key messages

  • In Germany, people with diabetes assess the quality of care as moderate.
  • Women with diabetes rate the quality of care lower than men with diabetes do.
  • There are slight regional but no educational differences in the self-assessed quality of care.

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Results

In 2017, the self-assessed quality of care for people aged 45 years and older with known diabetes in the last 12 months is in the middle range with 2.45 on a scale of 1 to 5 and is lower for women than for men (2.32 vs 2.57). Lower ratings of quality of care are associated with increasing age. The PACIC-DSF sum score for people aged 45 to 64 years is 2.67, but 2.13 for people aged 80 years or above. No differences were identified in self-assessed quality of care by education. People in the Central-East (2.59) region provided a more positive assessment compared to those in the North-East (2.34) and Central-West (2.37) regions.

Conclusion

People with diabetes in Germany rate the quality of care that they receive as moderate. It could be useful to improve awareness about the condition and treatment as well as to more actively involve people who are affected by diabetes when dealing with the condition. This could help improve people’s perception of the quality of care that they receive.

Show more information on methodology and data sources

Definition

The indicator Self-assessed quality of care describes subjectively perceived quality of care and was determined using an adapted German-language version of the Patient Assessment of Chronic Illness Care-DAWN Short Form (PACIC-DSF). Figures are given as a mean value of the PACIC-DSF total score.

Operationalisation

  • Preliminary question: ‘What kind of help have you received from your treatment team for your diabetes management within the past 12 months?’
  • Nine questions were asked about help regarding medication, treatment plan and goals, diabetes management and treatment goals, support from the social environment and visits to self-help groups or diabetes education programs, as well as about follow-up contact after a visit to a medical practice and satisfaction with the way in which treatment was organised.
  • Answer options:

    • 1 = never
    • 2 = rarely
    • 3 = sometimes
    • 4 = often
    • 5 = always
  • Self-assessed quality of care: The PACIC-DSF total score is the sum of the scores gained from the answers provided to the nine questions divided by 9. The score has a scale ranging from 1 to 5, and higher values indicate higher levels of satisfaction with quality of care.

Reference population

People with known diabetes in the German-speaking resident population of Germany, aged 45 years and over

Data source

Nationwide RKI study ‘Disease knowledge and information needs – Diabetes mellitus (2017)’ of German-speaking residents in Germany aged 18 years and over. The study consisted of two parts (a representative part and a sample of the population with diabetes) and was based on a telephone sample (using landline and mobile numbers) and a telephone-based questionnaire.

The diabetes sample was collected using a special screening process that focused on the target group – people with known diabetes.

Number of cases

  • Diabetes sample: n = 1,479 (including 263 people with known diabetes from the representative part),
  • among them 1,254 people aged 45 years or over with known diabetes during the past 12 months as well as complete information on the PACIC-DSF score.

Calculation

  • Description: For the indicator, the figures for total, women and men are provided and are stratified by age group, residential area and education as far as the number of cases available for the figure is ≥ 5 and the statistical uncertainty in the estimate of the indicator is not considered too large (a coefficient variation ≤ 33.5%).
  • Stratification: The geographical classification of the residence of the participating person was carried out by region (north-east, north-west, middle-east, middle-west and south). Educational status was determined using the CASMIN index, which takes information on both school and vocational training into account and allows a categorisation into a low, medium and high education group.
  • Weighting: A weighting factor was used to correct for deviations from the underlying reference population due to different participation rates or sampling probabilities. This adjusts the study sample to the population structure of the reference population in terms of sex, age and education as of 31 December 2016. The distribution structure of people diagnosed with diabetes from the German Health Update 2012 (GEDA 2012), a nationwide study undertaken by the RKI, was used to calculate the weighting factor, since data from the population statistics provided by the Federal Statistical Office did not enable conclusions to be drawn about people diagnosed with diabetes in the German-speaking resident population aged 18 and over.

Data quality

The add-on survey ‘Disease knowledge and informational needs – diabetes mellitus’ (2017) provides representative results about people with and without diabetes from the German-speaking resident population of Germany aged 18 years and over. As with all population-based studies, it can be assumed that the study underrepresents people with serious illnesses and those currently in institutions. In addition, the survey data is based on information provided by the respondents.

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