Abstract
The responsiveness of a health system is considered to be an intrinsic goal of health systems and an essential aspect in performance assessment. Numerous studies have analysed health system responsiveness and related concepts, especially across different countries and health systems. However, fewer studies have applied the concept for the evaluation of specific healthcare delivery structures and thoroughly analysed its determinants within one country. The aims of this study are to assess the level of perceived health system responsiveness to patients with chronic diseases in ambulatory care in Germany and to analyse the determinants of health system responsiveness as well as its distribution across different population groups. The target population consists of chronically ill people in Germany, with a focus on patients suffering from type 2 diabetes and/or from coronary heart disease (CHD). Data comes from two different sources: (i) cross-sectional survey data from a postal survey and (ii) claims data from a German sickness fund. Data from both sources will be linked at an individual-level. The postal survey has the purpose of measuring perceived health system responsiveness, health related quality of life, experiences with disease management programmes (DMPs) and (subjective) socioeconomic background. The claims data consists of information on (co)morbidities, service utilization, enrolment within a DMP and sociodemographic characteristics, including the type of residential area. RAC is one of the first projects linking survey data on health system responsiveness at individual level with claims data. With this unique database, it will be possible to comprehensively analyse determinants of health system responsiveness and its relation to other aspects of health system performance assessment. The results of the project will allow German health system decision-makers to assess the performance of nonclinical aspects of healthcare delivery and their determinants in two important areas of health policy: in ambulatory and chronic disease care.
Highlights
In 2000 the World Health Organisation (WHO) defined “responsiveness to citizens’ legitimate expectations” as an intrinsic goal of health systems and, as a main aspect in the performance assessment of health systems.[1]
To allow for a thorough analysis of both aspects, the project follows two different approaches: in one study, general practitioners (GPs) and their respective patients will be surveyed; in the second, a survey is conducted of chronically ill patients in ambulatory care (GP and specialist care) and these survey data will subsequently be linked to individual level administrative claims data from a German sickness fund
The related WHO questionnaires, which have been used within the MCSS and the World Health Survey (WHS) 2002 to assess the responsiveness of health systems, we developed the German-language survey questionnaire
Summary
In 2000 the World Health Organisation (WHO) defined “responsiveness to citizens’ legitimate expectations” as an intrinsic goal of health systems and, as a main aspect in the performance assessment of health systems.[1]. Survey Study on Health and Responsiveness (MCSS),[2] the World Health Survey (WHS) 2002,3 the Survey of Health, Ageing and Retirement in Europe (SHARE)[4] and the Study on Global Ageing and Adult Health (SAGE).[5] Fewer studies applied the responsiveness concept for the evaluation of specific healthcare delivery structures or particular subgroups of the population and analysed its determinants within one country.[6,7,8] to our knowledge, data on health system responsiveness has not yet been linked to claims data (eg, from sickness funds) or other routinely collected medical data on individual level, allowing for thorough analysis regarding (co)morbidities or the utilization of health services This manuscript presents the study design and methodology of the project “Exploring health system Responsiveness in Ambulatory Care and disease management and its relation to other dimensions of health system performance” (RAC). Analyses will be based on a unique dataset – survey data on health system responsiveness linked to individual level administrative claims data from a German sickness fund – and will add important new aspects to the existing literature on health system responsiveness
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
