Impact of social inequalities on care and treatment process in patients with diabetes mellitus type 2. A qualitative study from the patient's perspective.

• Applicant: Dr. Astrid Fink
• Subject Area: Public Health, Healthcare Research, Social and Occupational Medicine
• Term: from 2014 to 2017
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 271504797

Social inequalities are often related with both, health inequalities as well as inequalities in health care. Often only a single sector of care (eg, acute care, rehabilitation therapy) was analyzed, which is why there are only fragmentary findings on the impact of social inequalities on the care for patients with diabetes mellitus type 2. The majority of studies also follow a quantitative approach, which often provides only descriptive results. It still remains unclear, where the social inequalities occur for the first time during care.The aim of the project is to explore the impact of social inequalities on access, utilization and perceived quality of health care in patients with diabetes mellitus type 2. The study will focus on the perspective of the patients in different treatment areas. The experiences of patients in the health system will also be taken into account. Analyses will determine, whether social inequalities are associated with the access, utilization and perceived quality of health care in different phases of care in patients with diabetes mellitus type 2. Further it will be examined, whether it is possible to identify factors that mediate the effect between social inequalities and disparities in health care.The study is designed as a qualitative cross-sectional study in the research paradigm of Grounded Theory. In three different areas of care a total of 30 participants will be recruited. Half of them will come from a deprived status group and the other half from a high status group. The data are collected by semi-structured interviews and qualitative analysis is followed by the design of a theory.In this project, we will identify the key points in the course of care, where the patient experiences vary from different social backgrounds. Thus, it provides a basis for a better explanation of social inequalities in health care. The theory developed can be used for an empirical test in a following project. This would supplement the existing explanations for the production of inequalities health and health care.

• DFG Programme: Research Grants