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 sum 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 about help regarding medication, treatment plan and goals, diabetes management and treatment goals, support from the social environment and being encouraged to visit 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 sum 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

2017: 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 (Paprott 2018). The diabetes sample was collected using a special screening process that focused on the target group ‘people with known diabetes aged 18 years and over’.

2021: Nationwide RKI survey GEDA 2021/2022-Diabetes based on a special screening process that focused on the target group ‘people with known diabetes aged 18 years’ (GEDA 2021/22-Diabetes).

Number of cases

• 2017:

  • 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.

• 2021:

  • GEDA 2021/2022-Diabetes: n = 1.503,
  • among them 1,260 people aged 45 years or over with known diabetes during the past 12 months as well as complete information on the PACIC-DSF sum 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. It adjusts the surveys sample to the population structure of the reference population in terms of sex, age and education as of 31 December 2016 (study ‘Disease knowledge and information needs – Diabetes mellitus (2017)’) and 31 December 2019 (GEDA 2021/2022-Diabetes). The distribution structure of people diagnosed with diabetes from the two nationwide RKI surveys German Health Update 2012 (GEDA 2012) and 2019 (GEDA 2019/2020-EHIS) were used to calculate the weighting factor, since data from the population statistics provided by the Federal Statistical Office do not allow conclusions about people diagnosed with diabetes in the German-speaking resident population aged 18 years and over.
• Age standardisation: Age standardisation was carried out with the reference population of adult residents in Germany as of 31 December 2019.

Data quality

The RKI surveys ‘Disease knowledge and informational needs – diabetes mellitus’ (2017) and GEDA 2021/2022 provide representative results about people with known 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. Comparisons of findings to previous RKI surveys are limited due to differences in methodology.