Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-11T10:51:26.709Z Has data issue: false hasContentIssue false
  • English
  • Français

Development and spatial representation of synthetic indexes of outpatient mental health care in Andalusia (Spain)

Published online by Cambridge University Press:  11 April 2011

Marco Garrido-Cumbrera ,
José Almenara-Barrios ,
Enrique López-Lara ,
Juan Luis Peralta-Sáez ,
Juan Carlos García-Gutierrez  and
Luis Salvador-Carulla
Marco Garrido-Cumbrera*
Affiliation:
Agéncia de Salut Pública de Barcelona, CIBER Epidemiologia y Salud Pública CIBERESP (Spain)
José Almenara-Barrios
Affiliation:
Área de Medicina Preventiva y Salud Pública (Bioestadìstica), Universidad de Cádiz, Cadiz (Spain) Asociación Científica Psicost, Jerez (Spain)
Enrique López-Lara
Affiliation:
Área de Análisis Geogràfico Regional, Universidad de Sevilla, Sevilla (Spain)
Juan Luis Peralta-Sáez
Affiliation:
Asociación Científica Psicost, Jerez (Spain) Departamento de Estadística e Investigación Operativa, Universidad de Cádiz, Cadiz (Spain)
Juan Carlos García-Gutierrez
Affiliation:
Grupo de Investigación en Medicina Psicosocial, Universidad de Cádiz, Cadiz (Spain)
Luis Salvador-Carulla
Affiliation:
Asociación Científica Psicost, Jerez (Spain) Grupo de Investigación en Medicina Psicosocial, Universidad de Cádiz, Cadiz (Spain)
*
Dr. M. Garrido Cumbrera, Departemento de Geografia, Universidad de Sevilla, C/Maria de Padilla s/n, Sevilla 1004 (Spain). E-mail: marcogarridocumbrera@yahoo.es
Get access Rights & Permissions [Opens in a new window]

Summary

Introduction – There is a need to develop composite indicators to monitor mental health care in countries such as Spain, where there is wide variability of care systems in 17 different regions. The aim of this study is to generate and to test the usability of synthetic indexes in Andalusia (Southern Spain). Method – Seven mental health indicators were selected by expert opinion from a previous list of simple indicators used to compare mental health care systems across Spain (Psicost-74). A Geographical Information Systems (GIS) was used to delineate 71 sectors based on the catchment areas of the mental health centers in Andalusia. Synthetic indexes were obtained through linear combinations of simple indicators via Principal Components Analysis (PCA), using activity data from the Mental Health Information System of Andalusia (SISMA). Maps of these indexes were drawn for 71 catchment areas. Results – Two synthetic indexes were obtained and showed high consistency in the PCA. The Care Load Index (component 1) related to population size and total outpatient care provided within the area. The Case Load Index (component 2) related to assisted morbidity in relation to the population size. The care load index was higher in populated urban areas, whereas the case load was higher in rural areas. Discussion – Care and case load indexes show a different pattern in urban and rural areas. This may be related to a different underlying model of care related to the degree of urbanisation. Geographical Information Systems (GIS) improved recognition and assessment of the spatial phenomena related to the mental health care system, and support policy decision making process in mental health.

Declaration of Interest: None.

Keywords

mental healthhealth information systemindicatorsPrincipal Components Analysis (PCA)Geographical Information System (GIS)
Type
Special Articles
Information
Epidemiology and Psychiatric Sciences , Volume 17 , Issue 3 , September 2008 , pp. 192 - 200
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Almenara, J., García-Ortega, C., González-Caballero, J.L. & Abellán-Hervás, M.J. (2002). Creación de índices de gestión hospitalaria mediante análisis de componentes principales. Salud Pública de México 44(6), 533–540.Google Scholar
Asociación Española de Neuropsiquiatría (AEN) (2007). Análisis de la Situación de la Atención a la Salud Mental en las Comunidades Autónomas a Diciembre del 2005. El Observatorio de Salud Mental de la Asociación Española de Neuropsiquiatría (AEN). Cuadernos técnicos, 7. AEN: Madrid. Retrieved January 20, 2008, from http://www.aen.es/web/docs/ObservatorioAEN_05.pdfGoogle Scholar
Salud, Consejería de, Andalucía, Junta de (2006). Trastorno Mental Grave: Proceso Asistencial Integrado. Servicio Andaluz de Salud, Consejería de Salud: Sevilla.Google Scholar
García-Ortega, C., Almenara-Barrios, J. & García-Ortega, J.J. (1998). Tasa de reingresos de un hospital comarcal. Revista Española de Salud Pública 72(2), 103–110.CrossRefGoogle Scholar
Garrido-Cumbrera, M., Salinas, J.A., Almenara, J. & Salvador-Carulla, L. (2005). Atlas de Salud Mental de Andalucía 2005. Consejería de Salud de la Junta de Andalucía: Sevilla Retrieved January 20, 2008, from http://www.aan.org.es/Atlas_SM.pdfGoogle Scholar
Grigoletti, L., Amaddeo, F., Grassi, A., Boldrini, M., Chiappelli, M., Percudani, M., Catapano, F., Fiorillo, A., Bartoli, L., Bacigalupi, M., Albanese, P., Simonetti, S., Perali, F., De Agostini, P., Tansella, M. & Gruppo I-Psycost (2006).[Proposal for a new funding system for mental health departments. Results from an evaluative multicentre Italian study (I-psycost)] [Article in Italian]. Epidemioogia e Psichiatria Sociale 15(4), 295–306.Google Scholar
Harrison, J., Barrow, S. & Creed, F. (1995). Social deprivation and psychiatric admission rates among different diagnostic groups. British Journal of Psychiatry; 167, 456–462.Google Scholar
Jacob, K.S., Sharan, P., Mirza, I., Garrido-Cumbrera, M., Seedat, S., Mari, J.J., Sreenivas, V. & Saxena, S. (2007). Mental health systems in countries: where are we now? Lancet 22, 370 (9592), 1061–1077.CrossRefGoogle Scholar
Jarman, B., Hirsh, S., White, P. & Driscoll, R. (1992). Predicting psychiatric admission rates. British Medical Journal 304, 1147–1151.Google Scholar
Jolliffe, I.T. (2002). Principal Component Analysis. Springer Verlag: New York.Google Scholar
Koppel, S. & McGuffin, P. (1999). Socio-economic factors that predict psychiatric admissions at local level. Psychological Medicine 29, 1235–1241.Google Scholar
Ministerio de Sanidad y Consumo (2002). Informe de Situación de Salud Mental. Ministerio de Sanidad y Consumo: Madrid.Google Scholar
Ministerio de Sanidad y Consumo (2007). Estrategia en Salud Mental del Sistema Nacional de Salud. Madrid: Ministerio de Sanidad y Consumo. Retrieved January 0, 2008, from http://www. msc.es/organizacion/sns/planCalidadSNS/pdf/excelencia/salud_me ntal/ESTRATEGIA_SALUD_MENTAL_SNS_PAG_WEB.pdfGoogle Scholar
Moreno-Kustner, B. (2008). Situación actual de los sistemas de información sobre salud mental en España. Monografías de Psiquiatría 20 (1), 4–14.Google Scholar
Salvador-Carulla, L., Tibaldi, G., Johnson, S., Scala, E., Romero, C. & Munizza, C., CSRP group & RIRAG group (2005). Patterns of mental health service utilisation in Italy and Spain: an investigation using the European Service Mapping Schedule. Social Psychiatry and Psychiatric Epidemiology. 40(2), 149–159.Google Scholar
Salvador-Carulla, L., Haro, J.M. & Ayuso-Mateos, J.L. (2006a). A framework for evidence-based mental health care and policy. Acta Psychiatrica Scandinavica, Suppl No. 432, 5–11.CrossRefGoogle Scholar
Salvador-Carulla, L., Garrido, M., McDaid, D. & Haro, J.M. (2006b). Financing mental health care in Spain. European Journal of Psychiatry 20(1), 29–44.Google Scholar
Salvador-Carulla, L., García-Alonso, C., Gonzalez-Caballero, J.L. & Garrido-Cumbrera, M. (2007). Use of an operational model of community care to assess technical efficiency and benchmarking of small mental health areas in Spain. Journal of Mental Health Policy and Economics 10, 87–100.Google Scholar
Salvador-Carulla, L., Saldivia, S., Martinez-Leal, R., Vicente, B., Garcia-Alonso, C., Grandon, P. & Haro, J.M. (2008). Meso-Level comparison of mental health service availability and use in Chile and Spain. Psychiatric Services 59(4), 421–428.Google Scholar
Saxena, S., Sharan, P., Garrido-Cumbrera, M. & Saraceno, B. (2006). World Health Organization's Mental Health Atlas 2005: implications for policy development. World Psychiatry 5(3), 179–184.Google Scholar
Saxena, S., Lora, A., van Ommeren, M., Barret, T., Morris, J. & Saraceno, B. (2007). WHO's assessment instrument for mental health systems: Collecting essential information for policy and service delivery. Psychiatric Services 58, 816–821.Google Scholar
Vazquez-Polo, F.J., Negrin, M.A., Salvador-Carulla, L., Cabasés, J.M. & Sanchez, E. (2007). Geographical differences in cost of schizophrenia in Spain: A Bayesian mapping approach. Journal of Mental Health Policy and Economics 10, Suppl. 1, s44.Google Scholar
Veugelers, P.J., Yip, A.M. & Elliott, D.C. (2003). Geographic variation in health services use in Nova Scotia. Chronic Diseases in Canada 24(4), 116–123.Google ScholarPubMed
Wang, J.L. (2004). Rural-urban differences in the prevalence of major depression and associated impairment. Social Psychiatry and Psychiatric Epidemiology Jan 39 (1), 19–25.Google Scholar
World Health Organization (2000). WHOTERM. WHO Terminology Information System. A Quick Reference Compendium of Selected Key Terms used in The World Health Report 2000 issued by the World Health Organization. Retrieved January 20, 2008, from http://www.who.int/health-systems-performance/docs/whr_ 2000_glossary.doc.Google Scholar