National Projects

Reference: PI15/01986

Title: Effect of financing systems on the quality of mental health in Spain

Funding entity and call: Instituto de Salud Carlos III, 2015

Principal Investigator: Carlos Ramón García Alonso, María Luisa Rodero Cosano (Loyola Andalucía University)

Start and end date: 2016-2018

Amount of the grant: 63,525


Today, there is no doubt that mental disorders are one of the greatest public health problems. Despite the existence of similar prevalence rates of mental health illnesses throughout Spain, different financing systems coexist due to the transfer of powers in this area to the Autonomous Communities. This may lead to differences in the quality of patient care. A comparison of several of these different financing systems using economic indicators, quality of care and degree of accessibility will allow a diagnosis of the current situation. Its results will make it possible to present evidence-based recommendations that can potentially guide political and technical decisions leading to the improvement of the quality of patient care having

To this end, the following work methodologies, among others, will be used: (i) multivariate econometric models for the study of variables and obtaining composite indicators, (ii) structural equation models for the study of causal relationships between variables, indicators and factors affecting patient care pathways (patterns of use) and quality of care, (iii) spatial analysis of data for the mapping of services classified in a standardised manner and, finally, (iv) analysis of relative technical efficiency using non-parametric techniques such as data envelopment analysis to determine potential improvements in the various financial systems analysed.





Part number: PI08/90752

Title: Identification, location and spatial analysis of areas of high prevalence of diseases with high social impact using artificial intelligence techniques

Funding entity and call: Instituto de Salud Carlos III, 2008

Principal Investigator: Carlos Ramón García Alonso (Loyola Andalucía University)

Start and end date: 2009-2010

Amount of the grant: 28,677


The project aims to design, develop and evaluate the results of a hybrid methodology for the identification, location and spatial and temporal analysis of geographical areas where the prevalence of a disease is significantly different from that observed in the rest of the area studied. These areas are called "hot-spots" (HS) and their study is essential in the management of health care for diseases with a strong social impact.

There are severe discrepancies in both approaches and results between the various methods that identify MSM in the territory. In this project a Multi-Objective Evolutionary Algorithm (MOEA) will be used, designed to hybridize the results obtained through the spatial analysis of the prevalence of the selected disease, namely: standard errors (Poisson), univariate local autocorrelations (Moran, Geary and Getis-Ord) and relative Bayesian risks (Conditional Auto-Regressive Model); all of them considered as objectives to be spatially optimized with a municipal basis in a Geographic Information System. In this way, it is intended to contemplate the problem from all possible methodological approaches to the problem posed. The MOEA, after the application of evolutionary operators (elitism is optional) and a sufficient number of iterations, will provide the probability of belonging to a spatial unit (municipality) to an HS. These probabilities express the degree of agreement between the techniques used, the identification of the HS will be done by means of statistics of the extremes (Q-Q Plots) and the spatial representation of the results will finally allow the definitive location of the HS.

The main results of the project will be: to design a protocol for the spatial and temporal analysis (2004 and 2006) of the prevalence of the disease (schizophrenia in the Autonomous Community of Andalusia), to evaluate the degree of spatial agreement between the different methods, to design a tool to carry out the effective hybridization of their results for the identification and localization of MH and finally the multivariate analysis of MH from a socio-economic, care level and accessibility point of view.


Reference: PI08/90101

Title: Validation of the Spanish version of the ESMS-II A tool for the standardized description and mapping of mental health services


Funding entity and call: Instituto de Salud Carlos III, 2008

Principal Investigator: Luis Salvador Carulla (Asociación Científica PSICOST)

Start and end date: 2009-2010

Amount of the grant: 36,058


FOUNDATION: The strategic lines of the Quality Plan for the National Health System (SNS) include among its objectives the creation of directories and territorial maps of the Mental Health services in the different Autonomous Communities. The most widely used international instrument for this purpose is the European Service Mapping Schedule (ESMS-I). The European MHEEN network in collaboration with the European Psychiatric Care Assessment Team (EPCAT) has developed within the MHEEN-II project a new instrument suitable for the assessment of new care systems (ESMS-II). MHEEN-II has recommended the adaptation of the instrument in different EU countries.

OBJECTIVES: Standardization and demonstration of the "usefulness" of the Spanish version of the ESMS-II in three ACs with different Mental Health systems.

METHODOLOGY: A conceptual translation of the English version of the ESMS-II is carried out, with adaptation of the content and analysis of viability in the Spanish context through a panel of experts. Study of its psychometric properties (reliability and validity). Demonstration study in six small sanitary areas of three ACs. Comparison of the usefulness of ESMS-I and ESMS-II.

EXPECTED RESULTS: 1) To contribute to the standardization of the ESMS-II in Spanish; 2) To provide the NHS with a health assessment tool useful for evidence-based decision-making and planning for comparison, monitoring and evaluation of available resources; 3) To contribute to the availability of standardized service information as well as equity in mental health care. To carry out the first national adaptation of the ESMS-II as a model for other European countries




Reference: PI11/02008

Title: Spatial analysis and ordinal classification of the geographical distribution of mental illness in Andalusia

Funding entity and call: Instituto de Salud Carlos III, 2011

Principal Investigator: Carlos Ramón García Alonso (Loyola Andalucía University)

Start and end date: 2012-2014

Amount of the grant: 23,440.12


The spatial analysis of the geographical distribution of the administrative prevalence of mental illnesses is currently receiving relevant attention from both the scientific world and all those who manage health resources and design socio-health policies.

The present project aims to design and develop a methodology that will allow for the relationship between the existence of statistically significant concentrations of the prevalence of specific mental illnesses (hot-spots and low-spots) and socio-demographic, economic and deprivation information (poverty indicator) by using statistical and computational intelligence-based methodologies. To this end, the following have been used: i) multiobjective evolutionary models to identify the aforementioned concentrations in different and relevant mental illnesses, ii) structural equation models to determine deprivation indices and iii) ordinal classification analysis (conventional and based on computational intelligence) to establish the relationships between sociodemographic, economic and deprivation information and the existence of the aforementioned concentrations.

The project has resulted in a new index of deprivation; the detection of spatial clusters of various mental illnesses; and the variables (or dimensions of the deprivation indicator) that most influence the description of the socio-economic characteristics of hot-spots and low-spots have been identified using methods based on computational intelligence.