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Romero-Lopez-Alberca C, Alonso-Trujillo F, Almenara-Abellan JL, Salinas-Perez JA, Gutierrez-Colosia MR, Gonzalez-Caballero JL, Pinzon Pulido S, Salvador-Carulla L. A Semiautomated Classification System for Producing Service Directories in Social and Health Care (DESDE-AND): Maturity Assessment Study. J Med Internet Res 2021; 23:e24930. [PMID: 33720035 PMCID: PMC8074989 DOI: 10.2196/24930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/19/2020] [Accepted: 12/17/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND DESDE-LTC (Description and Evaluation of Services and DirectoriEs for Long-Term Care) is an international classification system that allows standardized coding and comparisons between different territories and care sectors, such as health and social care, in defined geographic areas. We adapted DESDE-LTC into a computer tool (DESDE-AND) for compiling a directory of care services in Andalucia, Spain. OBJECTIVE The aim of this study was to evaluate the maturity of DESDE-AND. A secondary objective of this study is to show the practicality of a new combined set of standard evaluation tools for measuring the maturity of health technology products. METHODS A system for semiautomated coding of service provision has been co-designed. A panel of 23 domain experts and a group of 68 end users participated in its maturity assessment that included its technology readiness level (TRL), usability, validity, adoption (Adoption Impact Ladder [AIL]), and overall degree of maturity [implementation maturity model [IMM]). We piloted the prototype in an urban environment (Seville, Spain). RESULTS The prototype was demonstrated in an operational environment (TRL 7). Sixty-eight different care services were coded, generating fact sheets for each service and its geolocation map. The observed agreement was 90%, with moderate reliability. The tool was partially adopted by the regional government of Andalucia (Spain), reaching a level 5 in adoption (AIL) and a level 4 in maturity (IMM) and is ready for full implementation. CONCLUSIONS DESDE-AND is a usable and manageable system for coding and compiling service directories and it can be used as a core module of decision support systems to guide planning in complex cross-sectoral areas such as combined social and health care.
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Affiliation(s)
- Cristina Romero-Lopez-Alberca
- Department of Psychology, Universidad de Cádiz, Cádiz, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Federico Alonso-Trujillo
- Agencia de Servicios Sociales y Dependencia de Andalucía, Junta de Andalucía, Sevilla, Spain
- Health Information Systems Group (SICA-CTS-553), Universidad de Cádiz, Cádiz, Spain
| | - Jose Luis Almenara-Abellan
- Health Information Systems Group (SICA-CTS-553), Universidad de Cádiz, Cádiz, Spain
- Hospital Universitario Reina Sofía, Servicio Andaluz de Salud, Córdoba, Spain
| | - Jose A Salinas-Perez
- Department of Quantitative Methods, Universidad Loyola Andalucía, Sevilla, Spain
- Centre for Mental Health Research, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australia
| | | | | | - Sandra Pinzon Pulido
- Escuela Andaluza de Salud Pública, Gobierno Regional de la Junta de Andalucía, Granada, Spain
| | - Luis Salvador-Carulla
- Centre for Mental Health Research, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australia
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Romero-López-Alberca C, Gutiérrez-Colosía MR, Salinas-Pérez JA, Almeda N, Furst M, Johnson S, Salvador-Carulla L. Standardised description of health and social care: A systematic review of use of the ESMS/DESDE (European Service Mapping Schedule/Description and Evaluation of Services and DirectoriEs). Eur Psychiatry 2019; 61:97-110. [PMID: 31426008 DOI: 10.1016/j.eurpsy.2019.07.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/27/2019] [Accepted: 07/26/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Evidence-informed planning and interpretation of research results both require standardised description of local care delivery context. Such context analysis descriptions should be comparable across regions and countries to allow benchmarking and organizational learning, and for research findings to be interpreted in context. The European Service Mapping Schedule (ESMS) is a classification of adult mental health services that was later adapted for the assessment of health and social systems research (Description and Evaluation of Services and DirectoriEs - DESDE). The aim of the study was to review the diffusion and use of the ESMS/DESDE system in health and social care and its impact in health policy and decision-making. METHOD We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (1997-2018). RESULTS Out of 155 papers mentioning ESMS/DESDE, 71 have used it for service research and planning. The classification has been translated into eight languages and has been used by seven international research networks. Since 2000, it has originated 11 instruments for health system research with extensive analysis of their metric properties. The ESMS/DESDE coding system has been used in 585 catchment areas in 34 countries for description of services delivery at local, regional and national levels. CONCLUSIONS The ESMS/DESDE system provides a common terminology, a classification of care services, and a set of tools allowing a variety of aims to be addressed in healthcare and health systems research. It facilitates comparisons across and within countries for evidence-informed planning.
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Affiliation(s)
| | | | - José A Salinas-Pérez
- Department of Quantitative Methods, Universidad Loyola Andalucía, Seville, Asociación Científica Psicost, Spain
| | - Nerea Almeda
- Department of Psychology, Universidad Loyola Andalucía, Seville, Spain
| | - Maryanne Furst
- Centre for Mental Health Research, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australia
| | - Sonia Johnson
- Division of Psychiatry, University College London, London, UK
| | - Luis Salvador-Carulla
- Centre for Mental Health Research, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra. Menzies Centre for Health Policy, University of Sydney, Australia
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Cetrano G, Salvador-Carulla L, Tedeschi F, Rabbi L, Gutiérrez-Colosía MR, Gonzalez-Caballero JL, Park AL, McDaid D, Sfetcu R, Kalseth J, Kalseth B, Hope Ø, Brunn M, Chevreul K, Straßmayr C, Hagmair G, Wahlbeck K, Amaddeo F. The balance of adult mental health care: provision of core health versus other types of care in eight European countries. Epidemiol Psychiatr Sci 2018; 29:e6. [PMID: 30328401 PMCID: PMC8061296 DOI: 10.1017/s2045796018000574] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 08/17/2018] [Accepted: 09/10/2018] [Indexed: 12/02/2022] Open
Abstract
AIMS Although many mental health care systems provide care interventions that are not related to direct health care, little is known about the interfaces between the latter and core health care. 'Core health care' refers to services whose explicit aim is direct clinical treatment which is usually provided by health professionals, i.e., physicians, nurses, psychologists. 'Other care' is typically provided by other staff and includes accommodation, training, promotion of independence, employment support and social skills. In such a definition, 'other care' does not necessarily mean being funded or governed differently. The aims of the study were: (1) using a standard classification system (Description and Evaluation of Services and Directories in Europe for Long Term Care, DESDE-LTC) to identify 'core health' and 'other care' services provided to adults with mental health problems; and (2) to investigate the balance of care by analysing the types and characteristics of core health and other care services. METHODS The study was conducted in eight selected local areas in eight European countries with different mental health systems. All publicly funded mental health services, regardless of the funding agency, for people over 18 years old were identified and coded. The availability, capacity and the workforce of the local mental health services were described using their functional main activity or 'Main Types of Care' (MTC) as the standard for international comparison, following the DESDE-LTC system. RESULTS In these European study areas, 822 MTCs were identified as providing core health care and 448 provided other types of care. Even though one-third of mental health services in the selected study areas provided interventions that were coded as 'other care', significant variation was found in the typology and characteristics of these services across the eight study areas. CONCLUSIONS The functional distinction between core health and other care overcomes the traditional division between 'health' and 'social' sectors based on governance and funding. The overall balance between core health and other care services varied significantly across the European sites. Mental health systems cannot be understood or planned without taking into account the availability and capacity of all services specifically available for this target population, including those outside the health sector.
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Affiliation(s)
- G. Cetrano
- Social Care Workforce Research Unit, King's Policy Institute, King's College London, London, UK
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - L. Salvador-Carulla
- Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
- PSICOST Research Association, Jerez de la Frontera, Spain
| | - F. Tedeschi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - L. Rabbi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - M. R. Gutiérrez-Colosía
- PSICOST Research Association, Jerez de la Frontera, Spain
- Departamento de Psicología, Universidad Loyola Andalucía, Sevilla, Spain
| | | | - A.-L. Park
- Personal Social Services Research Unit, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - D. McDaid
- Personal Social Services Research Unit, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - R. Sfetcu
- Institute for Economic Forecasting, Bucharest, Romania
- Faculty of Psychology and Educational Sciences, University Spiru Haret, Bucharest, Romania
| | - J. Kalseth
- Department of Health Research, SINTEF, Trondheim, Norway
| | - B. Kalseth
- Department of Health Research, SINTEF, Trondheim, Norway
| | - Ø. Hope
- Department of Health Research, SINTEF, Trondheim, Norway
| | - M. Brunn
- Université Paris Diderot, Sorbonne, Paris, France
- Inserm, ECEVE, U1123, F-75 010, Paris, France
- AP-HP, URC-Eco, Paris, France
| | - K. Chevreul
- Université Paris Diderot, Sorbonne, Paris, France
- Inserm, ECEVE, U1123, F-75 010, Paris, France
- AP-HP, URC-Eco, Paris, France
| | | | - G. Hagmair
- IMEHPS.research, Vienna, Austria
- Department for Cultural Analysis, Universitaet Klagenfurt, Klagenfurt, Austria
| | - K. Wahlbeck
- Department of Mental Health, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - F. Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Sadeniemi M, Almeda N, Salinas-Pérez JA, Gutiérrez-Colosía MR, García-Alonso C, Ala-Nikkola T, Joffe G, Pirkola S, Wahlbeck K, Cid J, Salvador-Carulla L. A Comparison of Mental Health Care Systems in Northern and Southern Europe: A Service Mapping Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1133. [PMID: 29857556 PMCID: PMC6024953 DOI: 10.3390/ijerph15061133] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 05/21/2018] [Accepted: 05/30/2018] [Indexed: 11/16/2022]
Abstract
Mental health services (MHS) have gone through vast changes during the last decades, shifting from hospital to community-based care. Developing the optimal balance and use of resources requires standard comparisons of mental health care systems across countries. This study aimed to compare the structure, personnel resource allocation, and the productivity of the MHS in two benchmark health districts in a Nordic welfare state and a southern European, family-centered country. The study is part of the REFINEMENT (Research on Financing Systems' Effect on the Quality of Mental Health Care) project. The study areas were the Helsinki and Uusimaa region in Finland and the Girona region in Spain. The MHS were mapped by using the DESDE-LTC (Description and Evaluation of Services and Directories for Long Term Care) tool. There were 6.7 times more personnel resources in the MHS in Helsinki and Uusimaa than in Girona. The resource allocation was more residential-service-oriented in Helsinki and Uusimaa. The difference in mental health personnel resources is not explained by the respective differences in the need for MHS among the population. It is important to make a standard comparison of the MHS for supporting policymaking and to ensure equal access to care across European countries.
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Affiliation(s)
- Minna Sadeniemi
- Department of Social Services and Health Care, City of Helsinki, Southern Psychiatric Outpatient Clinic, Työpajankatu 14, FI-00099 Helsinki, Finland.
- University of Helsinki and Helsinki University Hospital, Välskärinkatu 12, Helsinki FI-00029, Finland.
- Unit for Mental Health, National Institute for Health and Welfare (THL); Mannerheimintie 168, Helsinki FI-00270, Finland.
| | - Nerea Almeda
- PSICOST Research Association, Department of Psychology, Universidad Loyola Andalucía, C/Energía Solar 1, 41014 Sevilla, España.
| | - Jose A Salinas-Pérez
- PSICOST Research Association, Department of Quantitative Methods, Universidad Loyola Andalucía, C/Energía Solar 1, 41014 Sevilla, España.
| | - Mencía R Gutiérrez-Colosía
- PSICOST Research Association, Department of Psychology, Universidad Loyola Andalucía, C/Energía Solar 1, 41014 Sevilla, España.
| | - Carlos García-Alonso
- PSICOST Research Association, Department of Quantitative Methods, Universidad Loyola Andalucía, C/Energía Solar 1, 41014 Sevilla, España.
| | - Taina Ala-Nikkola
- University of Helsinki and Helsinki University Hospital, Välskärinkatu 12, Helsinki FI-00029, Finland.
- Unit for Mental Health, National Institute for Health and Welfare (THL); Mannerheimintie 168, Helsinki FI-00270, Finland.
| | - Grigori Joffe
- University of Helsinki and Helsinki University Hospital, Välskärinkatu 12, Helsinki FI-00029, Finland.
| | - Sami Pirkola
- University of Tampere School of Health Sciences, and Tampere University Hospital, Lääkärinkatu 1, Tampere FI-33014, Finland.
| | - Kristian Wahlbeck
- Unit for Mental Health, National Institute for Health and Welfare (THL); Mannerheimintie 168, Helsinki FI-00270, Finland.
| | - Jordi Cid
- Mental Health & Addiction Research Group, Institut d'Investigacions Biomèdiques de Girona (IdibGI)-Institut d'Assistència Sanitària, 17190 Salt Girona, Spain.
| | - Luis Salvador-Carulla
- VIDEA Lab, Centre for Mental Health Research, Australian National University, 63 Eggleston Rd, Acton ACT 2601, Australia.
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