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

社会不平等往往既与健康不平等有关，也与医疗保健方面的不平等有关。通常只分析了一个护理部门(如急性护理、康复治疗)，这就是为什么关于社会不平等对2型糖尿病患者护理的影响只有零星的发现。大多数研究也遵循定量的方法，这往往只提供描述性的结果。目前尚不清楚，社会不平等在护理期间首次出现在哪里。该项目的目的是探索社会不平等对2型糖尿病患者获得、利用和感知卫生保健质量的影响。研究将集中在不同治疗领域患者的视角。卫生系统中病人的经历也将被考虑在内。分析将确定社会不平等是否与2型糖尿病患者在不同护理阶段获得、利用和感知卫生保健的质量有关。此外，还将检查是否可能确定在社会不平等和卫生保健差异之间的影响的因素。本研究被设计为扎根理论研究范式中的定性横断面研究。在三个不同的护理领域，将总共招募30名参与者。他们中的一半将来自地位低下的群体，另一半来自地位较高的群体。在这个项目中，我们将确定护理过程中的关键点，其中患者的经历来自不同的社会背景。因此，它为更好地解释医疗保健中的社会不平等提供了基础。所开发的理论可用于后续项目的实证检验。这将补充现有对造成保健和保健不平等的解释。

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.