eTools for the standard classification of health and social services: eDESDE-LTC

Abstract

Background: The DESDE-LTC is a standardized international classification of services that allows mapping of social and health care based on the European Service Mapping Schedule (ESMS) developed for mental health services. This system provides a standard description of the whole array of services available for a target population both at horizontal and at vertical level allowing for the basic information required to assess integrated care. It is based in coding the “minimum units of production of care” within services called Basic Inputs of Care (BSICs). These units are labeled using the most meaningful activity or “Main Type of Care” (MTC). DESDE-LTC has been extensively used in different sectors such as mental health, disability, elderly and long term care, performed in over 17 countries both in Europe and America. However this system requires extensive training and periodical update of the information gathered. Innovation: In order to overcome this problem several eTools have been developed in the last 4 years. eDESDE-LTC (www.edesdeproject.eu/) is an electronic knowledge base that contains all the information required to code and use the classification system in long term care. It includes the reference documents (conceptual framework, usability, dissemination and reports), a toolkit (coding system, glossary and assessment instrument), and an on-line training package. The use of this knowledge base proved useful as complementary to but not as a replacement of face-to-face training is the DESDE-LTC project (Salvador-Carulla et al, 2011) and in the subsequent REFINEMENT project (Amaddeo et al, 2013). The Refinement Toolkit (http://www.refinementproject.eu/) is a decision support system for Mental Health that includes four major sets of tools: FINCENTO (analysis of financing), REQUALIT (quality of mental health care), REPATO (Pathways of care) and REMAST (service provision). REMAST includes the Verona Socio-demographic Scale (SES) and DESDE-LTC apart from other service information and Atlases of care in several European regions. The REFINEMENT toolkit provides relevant information for system analysis in mental health and for a better understanding of service provision but the need of training has not been modified from the previous knowledge base. In 2014 the Regional Government of Andalucia funded the project DESDE-AND to develop a computer algorithm for automatic collection of data and coding of social services, following an integrated care approach. This research has allowed to test the usability of the coding system outside the health sector and to improve Conclusions: The DESDE-LTC has proven its feasibility for the standard assessment of services in different fields, including mental health, disabilities, ageing, long-term care and social services. This indicates the generalisability of this taxonomy for mapping integrated care. The development of different electronic knowledge-bases and computer algorithms for data completion will be a key factor for the dissemination and spreading of this system.