Patients’ understanding of health information in Germany

Figures & data

Table 1 Translation of questions on patient–physician communication and on written health information in the 2017 national survey of health service users

Translated question
Did your physician’s explanations help you to better understand what your main health problem is?*
Did your physician’s explanations help you to better understand what exactly you could do about this health problem?*
Did your physician’s explanations help you to better understand why you should do this?*
When you read something on health, do you generally understand this very well, well, not well, or not well at all?

Note: *Respondents were informed that they were to provide their subjective assessment of their experience based on their last physician’s visit in the previous 12 months. Answer categories: “yes”, “no”.

Table 2 Description of the sample statistics (N for “Total” =6,105; n for “Last visit at GP“ =3,056; n for “Last visit at SP” =2,102; weighted)

	Total		Last visit at GP		Last visit at SP
	Quantity	Percentage*	Quantity	Percentage*	Quantity	Percentage*
Age  18 to 34 years  35 to 49 years  50 to 64 years  65 years and above	1,178 1,477 1,637 1,812	19.3 24.2 26.8 29.7	568 676 792 1,020	18.6 22.1 25.9 33.4	400 519 604 579	19.0 24.7 28.7 27.6
Gender  Female  Male	3,230 2,875	52.9 47.1	1,626 1,430	53.2 46.8	1,206 896	57.4 42.6
Educational status  Higher education  Intermediate education  Basic education  No degree  Still at school	1,974 1,969 1,952 86 40	32.8 32.7 32.4 1.4 0.7	892 961 1,095 40 27	29.6 31.9 36.3 1.3 0.9	779 687 577 27 7	37.5 33.1 27.8 1.3 0.3
Occupational status  Full-time  Part-time/temporary  Unemployed  Retired  Training/volunteering/school  Parental leave/not-employed	2,395 898 106 1,999 272 348	39.8 14.9 1.8 33.2 4.5 5.8	1,128 460 54 1,104 129 135	37.5 15.3 1.8 36.7 4.3 4.5	780 318 36 675 105 157	37.6 15.3 1.8 32.6 5.1 7.6
Type of health insurance  Private  Statutory	772 5,266	12.8 87.2	291 2,732	9.6 90.4	327 1,755	15.7 84.3
Self-reported health status  Excellent/very good  Good  Poor  Very poor	2,202 2,607 959 281	36.4 43.1 15.9 4.6	1,000 1,395 487 146	33.0 46.1 16.1 4.8	693 865 411 110	33.4 41.6 19.8 5.3
Chronic illness  No  Yes	3,040 3,015	50.2 49.8	1,421 1,609	46.9 53.1	872 1,209	41.9 58.1
Nationality  German  Other	5,814 281	95.4 4.6	2,923 128	95.8 4.2	1,999 101	95.2 4.8
Reason for last physician visit  Preventive examination, immunization  Chronic illness  Current problem  Other	1,063 1,058 2,158 218	23.6 23.5 48.0 4.9	552 542 1,314 93	22.1 21.7 52.5 3.7	510 511 842 125	25.7 25.7 42.3 6.3

Notes: *Of all valid answers. Differences of sums to 6,105 (total), 3,056 (GPs) and 2,102 (SPs): no answer.“Basic education” comprises eight or nine years of schooling; “intermediate” ten years; “higher” twelve or 13 years.

Abbreviations: GP, general practitioners; SP, specialists.Differences of sums to 6,105 (total), 3,056 (GPs) and 2,102 (SPs): no answer.“Basic education” comprises eight or nine years of schooling; “intermediate” ten years; “higher” twelve or 13 years.

Table 3 Bivariate results for respondents who last consulted a general practitioner (GP) (n=3,056; weighted)

Question on:	Main problem?		What to do?		Why do it?		Written materials?
Answer	Yes	No	Yes	No	Yes	No	Very well	Well	Not well	Not well at all
Total percentage	93.9	6.1	95.4	4.6	98.8	1.2	22.6	64.1	12.0	1.4
Age (total)  18 to 34 years  35 to 49 years  50 to 64 years  65 years and above	94.0 96.6 92.9 93.1 93.9	6.0 3.4 7.1 6.9 6.1	95.3 94.6 96.2 95.5 94.9	4.7 5.4 3.8 4.5 5.1	98.9 98.6 98.7 98.2 100.0	1.1 1.4 1.3 1.8 0.0	22.6 27.9 24.9 22.2 18.3	64.1 64.6 63.1 62.8 65.5	11.9 7.3 9.8 13.7 14.6	1.4 0.2 2.2 1.3 1.6
n	1,478		1,289		784		2,914
Gender (total)  Female  Male	94.0 93.8 94.2	6.0 6.2 5.8	95.3 95.5 95.1	4.7 4.5 4.9	98.9 99.0 98.7	1.1 1.0 1.3	22.5 23.7 21.3	64.1 64.0 64.2	12.0 11.1 13.0	1.4 1.2 1.5
n	1,478		1,289		783		2,914
Educational status (total)  Higher education  Intermediate education  Basic education	94.1 94.2 92.9 95.5	5.9 5.8 7.1 4.5	95.3 93.8 95.7 96.5	4.7 6.2 4.3 3.5	98.7 98.4 98.1 99.6	1.3 1.6 1.9 0.4	22.5 36.9 21.3 11.7	64.3 58.1 65.6 68.3	12.0 4.6 12.2 17.8	1.2 0.5 0.9 2.1
n	1,434		1,258		765		2,820
Occupational status (total)  Full-time  Part-time/temporary  Unemployed  Retired  Training/volunteering/  school  Parental leave/not- employed	93.9 92.9 94.2 100.0 93.7 97.2 97.2	6.1 7.1 5.8 0.0 6.3 2.8 2.8	95.6 95.8 93.6 100.0 95.2 100.0 96.9	4.4 4.2 6.4 0.0 4.8 0.0 3.1	98.8 98.5 98.6 100.0 99.0 100.0 100.0	1.2 1.5 1.4 0.0 1.0 0.0 0.0	22.7 24.0 29.2 11.5 18.1 32.8 20.2	64.2 64.0 59.9 78.8 65.6 59.0 67.4	11.8 10.5 9.1 7.7 14.9 8.2 12.4	1.4 1.5 1.8 1.9 1.4 0.0 0.0
n	1,458		1,272		775		2,869
Type of health insurance (total)  Private  Statutory	93.9 95.9 93.6	6.1 4.1 6.4	95.4 94.5 95.5	4.6 5.5 4.5	98.8 98.6 98.9	1.2 1.4 1.1	22.7 31.9 21.6	64.1 61.8 64.4	12.0 5.3 12.7	1.3 1.1 1.3
n	1,469		1,275		774		2,883
Self-reported health status (total)  Excellent/very good  Good  Poor  Very poor	94.1 95.5 94.2 92.3 87.7	5.9 4.5 5.8 7.7 12.3	95.4 93.8 96.3 95.8 96.2	4.6 6.2 3.7 4.2 3.8	98.8 97.7 99.5 100.0 97.4	1.2 2.3 0.5 0.0 2.6	22.5 30.2 18.9 17.7 20.6	64.2 59.0 67.3 67.1 60.3	11.9 9.8 12.1 14.3 16.9	1.4 1.0 1.7 0.9 2.2
n	1,468		1,280		781		2,891
Chronic illness (total)  No  Yes	93.9 94.3 93.5	6.1 5.7 6.5	95.4 95.8 94.9	4.6 4.2 5.1	98.8 99.0 98.7	1.2 1.0 1.3	22.3 22.0 22.6	64.3 66.3 62.5	12.0 10.5 13.4	1.4 1.2 1.6
n	1,466		1,276		779		2,892
Nationality (total)  German  Other	93.9 93.8 95.7	6.1 6.2 4.3	95.3 95.4 93.7	4.7 4.6 6.3	98.8 99.1 95.0	1.2 0.9 5.0	22.5 22.7 19.5	64.1 64.3 59.3	12.0 11.6 20.3	1.4 1.4 0.8
n	1,475		1,287		782		2,911
Reason for last physician visit (total)  Preventive examination/immunization  Chronic illness  Current problem	93.8 94.5 92.8 93.9	6.2 5.5 7.2 6.1	95.5 99.0 96.0 94.5	4.5 1.0 4.0 5.5	99.1 99.3 99.3 98.9	0.9 0.7 0.7 1.1	23.5 24.3 19.7 24.7	63.2 64.1 60.1 64.1	12.1 11.2 16.8 10.5	1.3 0.4 3.5 0.8
n	1,425		1,254		763		2,306

Notes: Differences of sums to 3,056: no answer. Gray background: statistically significant at p≤0.05.

Table 4 Bivariate results for respondents who last consulted a specialist (SP) (n=2,102; weighted)

Question:	Main problem?		What to do?		Why do it?		Written materials?
Answer	Yes	No	Yes	No	Yes	No	Very well	Well	Not well	Not well at all
Total percentage	93.0	7.0	95.8	4.2	97.4	2.6	25.5	64.2	9.3	1.0
Age (total) 18 to 34 years 35 to 49 years 50 to 64 years 65 years and above	93.0 95.9 93.4 92.2 91.4	7.0 4.1 6.6 7.8 8.6	95.8 95.4 96.1 95.8 96.0	4.2 4.6 3.9 4.2 4.0	97.5 97.0 99.4 96.6 96.5	2.5 3.0 0.6 3.4 3.5	25.5 31.9 29.1 24.5 18.5	64.2 63.6 62.0 66.5 64.3	9.3 4.5 8.0 8.9 14.4	1.0 0.0 0.8 0.2 2.8
n	1,207		936		629		1,991
Gender (total) Female Male	93.0 92.7 93.3	7.0 7.3 6.7	95.8 94.4 97.5	4.2 5.6 2.5	97.3 97.3 97.3	2.7 2.7 2.7	25.5 27.5 22.7	64.2 63.7 64.9	9.3 7.9 11.3	1.0 1.0 1.1
n	1,208		936		631		1,992
Educational status (total) Higher education Intermediate education Basic education	92.9 93.7 93.5 91.2	7.1 6.3 6.5 8.8	95.9 96.2 94.8 97.1	4.1 3.8 5.2 2.9	97.4 97.6 96.7 98.2	2.6 2.4 3.3 1.8	25.6 36.6 24.7 11.1	64.1 59.6 64.6 70.0	9.2 3.6 10.1 16.0	1.1 0.3 0.6 2.9
n	1,169		912		616		1,940
Occupational status (total) Full-time Part-time/temporary Unemployed Retired Training/volunteering/ school Parental leave/not- employed	92.9 93.5 95.6 100.0 91.1 93.5 89.4	7.1 6.5 4.4 0.0 8.9 6.5 10.6	96.0 97.5 95.8 83.3 95.5 90.2 96.6	4.0 2.5 4.2 16.7 4.5 9.8 3.4	97.3 96.9 98.0 100.0 96.5 100.0 100.0	2.7 3.1 2.0 0.0 3.5 0.0 0.0	25.3 29.2 26.0 23.5 18.3 34.4 28.1	64.3 63.6 65.1 64.7 64.9 63.5 64.1	9.4 6.5 8.9 11.8 14.4 2.1 7.8	1.0 0.7 0.0 0.0 2.4 0.0 0.0
n	1,188		924		625		1,962
Type of health insurance (total) Private Statutory	93.0 94.7 92.7	7.0 5.3 7.3	95.8 97.9 95.4	4.2 2.1 4.6	97.3 97.9 97.2	2.7 2.1 2.8	25.3 32.6 23.9	64.3 61.1 64.9	9.4 5.7 10.1	1.0 0.6 1.1
n	1,200		930		626		1,975
Self-reported health status (total) Excellent/very good Good Poor Very poor	93.1 94.9 93.6 92.7 80.6	6.9 5.1 6.4 7.3 19.4	96.1 96.4 95.6 96.4 97.6	3.9 3.6 4.4 3.6 2.4	97.5 99.0 97.7 95.6 93.3	2.5 1.0 2.3 4.4 6.7	25.4 34.8 20.7 19.3 24.0	64.3 58.7 68.8 64.4 64.0	9.3 5.9 9.9 13.7 10.0	1.1 0.6 0.6 2.5 2.0
n	1,203		932		628		1,971
Chronic illness (total) No Yes	93.0 94.6 91.7	7.0 5.4 8.3	96.1 95.7 96.4	3.9 4.3 3.6	97.5 97.1 97.7	2.5 2.9 2.3	25.7 27.3 24.5	64.0 63.9 64.0	9.3 8.3 10.1	1.0 0.5 1.4
n	1,198		929		628		1,970
Nationality (total) German Other	93.0 92.8 95.8	7.0 7.2 4.2	95.8 95.8 96.5	4.2 4.2 3.5	97.3 97.4 95.5	2.7 2.6 4.5	25.5 25.6 24.0	64.2 64.0 68.8	9.3 9.4 7.3	1.0 1.1 0.0
n	1,206		934		629		1,989
Reason for last physician visit (total) Preventive examination/immunization Chronic illness Current problem	93.0 95.6 90.6 93.1	7.0 4.4 9.4 6.9	96.0 95.5 94.7 96.8	4.0 4.5 5.3 3.2	97.1 98.2 95.5 97.6	2.9 1.8 4.5 2.4	24.9 24.7 25.8 24.5	64.9 66.6 61.1 66.2	9.2 7.7 11.8 8.6	1.0 1.0 1.3 0.8
n	1,126		881		596		1,763

Notes: Differences of sums to 2,102: no answer. Gray background: statistically significant at p≤0.05.

Table 5 Multivariable logistic regression results, for “Main problem”, “What to do”, “Why to do”: 0= “yes”, 1= “no”; for “Written materials”: 0= “well”, 1= “not well”

Question on:	Main problem?		What to do?		Why do it?		Written materials?
	Last visit at GP	Last visit at SP	Last visit at GP	Last visit at SP	Last visit at GP	Last visit at SP	Last visit at GP	Last visit at SP
Cases included in analysis	1,305	1,162	1,183	895	730	598	2,176	1,819
	OR (CI)	OR (CI)	OR (CI)	OR (CI)	OR (CI)	OR (CI)	OR (CI)	OR (CI)
Age  18 to 34 years  35 to 49 years  50 to 64 years  65 years and above	Ref. 2.33* (1.06–5.14) 2.06 (0.92–4.61) 1.71 (0.70–4.17)	Ref. 2.13 (0.78–5.82) 2.33 (0.86–6.31) 2.97* (1.10–8.00)	Ref. 0.39* (0.17–0.88) 0.52 (0.23–1.16) 0.78 (0.17–3.51)				Ref. 1.60 (0.97–2.64) 2.09* (1.29–3.41) 1.72* (1.03–2.88)	Ref. 1.80 (0.94–3.45) 1.56 (0.82–2.97) 2.66* (1.43–4.96)
Gender  Female  Male							Ref. 1.39* (1.07–1.80)
Educational status  Higher education  Intermediate education  Basic education							Ref. 2.66* (1.75–4.05) 4.20* (2.76–6.39)	Ref. 3.18* (1.95–5.16) 4.63* (2.84–7.54)
Occupational status  Full-time  Part-time/temporary  Unemployed  Retired  Training/volunteering/  school  Parental leave/not-employed			Ref. 2.44* (1.15–5.18) 0.00 1.80 (0.44–7.45) 0.05 (0.00–4.90) 0.87 (0.19–3.86)
Type of health insurance  Private  Statutory							Ref. 2.26* (1.17–4.35)
Self-reported health status  Excellent/very good  Good  Poor  Very poor	Ref. 1.12 (0.64–1.98) 1.87 (0.94–3.76) 3.17* (1.32–7.61)	Ref. 1.50 (0.79–2.84) 1.52 (0.71–3.26) 5.19* (2.23–12.10)
Nationality  German  Other							Ref. 3.78* (2.12–6.74)
Reason for last physician visit  Preventive examination/immunization  Chronic illness  Current problem			Ref. 2.46 (0.54–11.17) 6.54* (1.70–25.12)				Ref. 1.57* (1.09–2.25) 0.98 (0.69–1.38)

Notes: *Statistically significant at p≤0.05. Empty cell: result not significant. The predictor suffering from a chronic illness did not show any statistically significant results at the 5% significance level in any of the models.

Abbreviations: GP, general practitioners; SP, specialists; OR, odds ratios; CI, confidence intervals; Ref., reference category.

Data availability

The data that this study has drawn on may be provided upon request.