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Social inequalities of treatment and care for patients with diabetes mellitus type 2 (SODIA)

How social inequalities impact the course of treatment and care for patients with diabetes mellitus type 2. A qualitative study from the patient’s perspective. (SODIA)

Head of Project: Dr. Astrid Fink

Coordination: Eva-Maria Fach, Maximilian Werner

Duration: 01.04.2015 bis 31.07.2016

Funding Agency: 3rd Academy of the German Research Foundation for early-career researchers in health services research

In Germany, as in all modern societies, diabetes mellitus type 2 has a far-reaching impact on healthcare policies. This is not only because of its high incidence rate, but also because of an increased mortality mainly related to cardio-vascular diseases as well as diabetes-related secondary diseases. Countless medical, sociological and epidemiological studies have demonstrated that socioeconomic inequalities in diabetes mellitus type 2 affect groups with a low socioeconomic status to their disadvantage. International studies have shown that inequalities exist in relation to access and utilization, as well as in perceived quality of diabetes care to the disadvantage of patients with a low socioeconomic status. So far, knowledge of the impact of social inequalities on the quality of treatment for diabetes mellitus type 2 exists only fragmentarily since most of the time only one single sector of care has been analyzed. Moreover, the majority of studies that have been conducted in the past have used a quantitative approach, often providing only descriptive results.


This qualitative study will explore the impact of socioeconomic inequalities on access to, utilization and perceived quality of healthcare provision for patients with diabetes mellitus type 2. The study will focus on the perspectives of patients in different sectors of care and will also take into account patients’ previous experiences with the healthcare system. It seeks to examine whether socioeconomic inequalities are associated with access to, utilization and perceived quality of healthcare services during the different stages of healthcare for diabetes mellitus type 2. The study will also seek to answer the question whether specific factors can be identified that act as an intermediary between social inequalities and inequality within healthcare.


In this qualitative cross-sectional study, a minimum of 18 participants will be recruited in three different sectors of care (University hospital, general practitioner’s office, specialized diabetological practice. One half will come from a high socioeconomic status group, and the other half from a low socioeconomic status group. Data will be collected through semi-structured interviews.


In this project, key points in the course of healthcare provision at which experiences of patients with different socioeconomic backgrounds start to diverge will be identified. Thus, the study constitutes a foundation for a better explanation of socioeconomic inequalities in healthcare. The theory which will be formed can be empirically tested in a follow-up study. Thereby, existing theories about the production of inequalities in healthcare and health inequalities can be complemented.

Contact Person: Please contact Amelie Baumann (+49 (0)345 557-1168) if you have any further questions.