Use of the European Classification of services ‘DESDE-LTC’ for integral mapping of mental health in Catalonia (Spain)

Abstract

Purpose: The standard description of local provision of services is critical to guide decision making. The available codes for the classification of health services at ICF and SHA 2.0 do not provide enough granularity to guide planning in specific areas such as mental health where services depending from other sectors are relevant and where a complementary classification may be needed. DESDE-LTC is an European classification of services for long term care funded by the European Agency of Health and Consumer and released in 2011 Objectives: To use DESDE-LTC to produce the integral Atlas of the mental health care system of Catalonia (Spain) METHOD: DESDE-LTC has been used for mapping all regional services for persons with mental disorders in Catalonia including child and adolescent care, adult care, and main public sectors involving the departments of Health, Education, Social services, Labour and Justice. Service availability has been related to utilisation data from available health databases. Results: The Atlas indicates a significant increase of services in the last decade, although gaps have been described in care provision in some rural areas, as well as in child and adolescent care in the Southern part of Catalonia. This system also allowed for identifying outlayer services either in number of professionals or care capacity (places or beds). Gaps in reporting to the regional systems have also been identified either in relation to specific care provision (e.g. outpatient care provided by general hospitals) or by specific health districts. The standard information on service availability and capacity and the information on utilisation of hospital and outpatient services have been used for spatial analysis of administrative prevalence of mental disorders in Catalonia and for the analysis of the technical efficiency of small health areas in the mental care system.