Self-assessed quality of chronic care differs by socio-demographic factors in the German population

Abstract Background The patient's perspective on processes of care and on communication with healthcare providers can guide improvement of sustainable collaborative chronic disease management. We analysed self-assessed quality of chronic care by socio-demographic factors to identify different needs and potential for improvement of care in the German adult population. Methods In the nationwide, population-based ‘Health in Germany’ panel survey 2024, those who stated chronic illness care in the last six months were asked 11 items of the Patient Assessment of Chronic Illness Care (PACIC-S11) covering care elements of self-management support and patient-centred communication (answers ranging from ‘almost never’ to ‘always’). Higher mean values of the total score (scale 1-5) indicate higher quality of care. The mean total score is presented according to gender, age group and education (CASMIN). We also explored which care elements are least addressed. Results The analysis included 10,129 adults with chronic illness care who answered the PACIC-S11 completely. On average, quality of chronic care was rated as moderate (mean total score 2.67, 95% confidence interval 2.64-2.69). Female gender (2.59; 2.56-2.62) and younger age (18-44 years; 2.53; 2.47-2.58) were associated with a lower rated quality of care compared to male gender (2.76; 2.73-2.80) and age above 45 years (2.72; 2.69-2.74). People with a medium level of education (2.59; 2.56-2.61) rated the quality of care worse than people with a low (2.76; 2.71-2.81) and high (2.63; 2.60-2.67) level. Among the 11 care elements, encouragement to attend support groups or structured self-management education was most often (76.8%) stated as never or almost never offered by healthcare providers. Conclusions People rate quality of chronic care differently by gender, age and education. There is potential for improvement with regard to greater patient-orientation (e. g. encouragement to structured self-management education) in Germany. Key messages • There is still room for improvement in terms of comprehensive patient-centredness in chronic care in Germany, which may be addressed by encouragement to attend structured self-management education. • The results suggest a heterogeneity of chronic illness care needs in terms of gender, age and education.