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Open Access Research article

Applicability of the assessment of chronic illness care (ACIC) instrument in Germany resulting in a new questionnaire: questionnaire of chronic illness care in primary care

Jost Steinhaeuser1*, Katja Goetz1, Dominik Ose1, Katharina Glassen1, Iris Natanzon1, Stephen Campbell12, Joachim Szecsenyi1 and Antje Miksch1

Author Affiliations

1 Department of General Practice and Health Services Research, University of Heidelberg, Voßstraße 2, Heidelberg 69115, Germany

2 Health Sciences - Primary Care Research Group, University of Manchester, Williamson Building Oxford Road, Manchester M13 9PL, UK

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BMC Health Services Research 2011, 11:164  doi:10.1186/1472-6963-11-164

Published: 7 July 2011



The Chronic Care Model (CCM) is an evidence based, population based approach to improve care for people with chronic conditions. The Assessment of Chronic Illness Care (ACIC) instrument is widely used to measure to what extent within a healthcare system the CCM is implemented. The aim of this study was to translate and culturally adapt the ACIC Instrument for the German healthcare system.


For translating the ACIC instrument, principles of Good Practice for the Translation and Cultural Adaptation Process by the ISPOR Task Force were followed. Focus groups were additionally conducted with general practitioners to adapt the items culturally.


The ACIC instrument can not be used in the German healthcare system easily due to a multifaceted understanding of words, different levels of knowledge of the CCM and fundamental differences between health systems.


As following the CCM leads to benefits for patients with chronic illnesses, measuring to which extent it is implemented is of major interest. A new questionnaire using the CCM as its theoretical basis, sensitive to the healthcare systems of the host country has to be created. Knowledge transfer between countries by using an instrument from a different healthcare system can lead to a completely new questionnaire.