Use of the internacional classification DESDE-LTC for monitoring the social care system in Andalucía (Spain) DESDE-AND classification software

Abstract

Background/Objectives 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. The DESDE-AND project aims at 1) testing the usability of DESDE-LTC for the classification of social services, 2) developing a computer algorithm for automatic collection of data and coding, following an integrated care approach, and 3) Incorporation to Geographical Information Systems. Methods First the usability of the DESDE-LTC taxonomy was assessed by a group of experts in social services. This included the revision of the functional definition of all social service types and its assignment within the management structure of social care. Second DESDE-LTC was used for coding prototypes of the whole class of social services listed at the official catalogue of social services in different Council of Andalusia Regional Government (Spain). Third, a pilot study was conducted in a catchment area of Seville comprising a wide variety of typologies of care. A feasibility analysis was performed with key decision makers in the field. Results This research has allowed to test the usability of the coding system outside the health sector and to improve it. The DESDE-LTC was used for coding and mapping social services with very minor modifications. As expected, modifications had to be made in the coding of the target population which was extended to frailty groups, deprivation, homelessness, migrants and others. Similarly additional qualifiers were included to better describe the social services from the perspective of the official agency in Andalusia. This included qualifiers for ‘transport’ and ‘dining’. 165 services of Seville area were codified with different validation levels. All coded services were incorporated to Andalusian Social Services Geographical Information Systems. Discussion/Conclusion Minor changes where required in the tree taxonomy of the “Main Types of Care” only for one final code R14 Other non-acute residential care: TIME LIMITED REGULATED (R14.1) i.e: family meeting flats for divorced couples with non-shared custody where lack of monitoring might entail some risk of abuse or kidnapping. TIME LIMITED NON REGULATED (R14.2) i.e: homes for children of prisoners. TIME LIMITED NON DIRECT CARE (R14.3) i.e: temporary housing for loss of persona home. The feasibility questionnaire showed that DESDE-LTC is acceptable and applicable for coding and mapping social services. The use of the algorithm in the assessment highly improved the practicality of the instrument and reduced the need of training although expert knowledge is still needed. The DESDE-LTC has proven its feasibility for the assessment of social services. This indicates the generalizability 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 as well as its incorporation to Geographical Information Systems.