title: Exploring Health System Responsiveness in Ambulatory Care and Disease Management and its Relation to Other Dimensions of Health System Performance (RAC) - Study Design and Methodology.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Health Care Management, Berlin Centre for Health Economics Research, Technische Universität Berlin, Berlin, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Röttger
authors.affiliation: Department of Health Care Management, Berlin Centre for Health Economics Research, Technische Universität Berlin, Berlin, Germany.
authors.forename: Miriam
authors.initials: M
authors.lastname: Blümel
authors.affiliation: Wissenschaftliches Institut der TK für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Engel
authors.affiliation: Wissenschaftliches Institut der TK für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg, Germany.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Grenz-Farenholtz
authors.affiliation: Department of Health Care Management, Berlin Centre for Health Economics Research, Technische Universität Berlin, Berlin, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Fuchs
authors.affiliation: Wissenschaftliches Institut der TK für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg, Germany.
authors.forename: Roland
authors.initials: R
authors.lastname: Linder
authors.affiliation: Wissenschaftliches Institut der TK für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Verheyen
authors.affiliation: Department of Health Care Management, Berlin Centre for Health Economics Research, Technische Universität Berlin, Berlin, Germany.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Busse
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000458:organization & administration*; D002908:Chronic Disease / Q000628:therapy*; D003327:Coronary Disease / Q000453:epidemiology / Q000628:therapy*; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000458:organization & administration*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000628:therapy*; D019468:Disease Management; D017598:Efficiency, Organizational / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Claims Data; Data Linkage; Disease Management  Programs; Health System Responsiveness; Patient Orientation; Survey Data