Secular trend in the incidence of hip fracture in Catalonia, Spain, 2003-2014.

Objectives: to describe the secular trend and seasonal variation in the incidence of hip fracture (HF) over 12 years (2003-2014) in Catalonia, the community with the highest incidence of HF in Spain.

Methods: data about age, gender, type of fracture and month of hospitalisation among patients aged 65 years and older discharged with a diagnosis of HF were collected. Crude and age-standardised annual incidence rate were reckoned.

Cross-sectional study comparing public and private hospitals in Catalonia: is the practice of routine episiotomy changing?

Background: In Spain, the Strategy for Assistance in Normal Childbirth (SANC) promoted a model of care, which respects the physiological birth process and discards unnecessary routine interventions, such as episiotomies. We evaluated the rate of episiotomy use and perineal trauma as indicators of how selective introduction of the SANC initiative has impacted childbirth outcomes in hospitals of Catalonia.

Methods: Cross-sectional study of all singleton vaginal term deliveries without instrument registered in the Minimum Basic Data Set (MBDS) of Catalonia in 2007, 2010 and 2012.

Obstetric interventions in two groups of hospitals in Catalonia: a cross-sectional study.

Background: Childbirth assistance in highly technological settings and existing variability in the interventions performed are cause for concern. In recent years, numerous recommendations have been made concerning the importance of the physiological process during birth. In Spain and Catalonia, work has been carried out to implement evidence-based practices for childbirth and to reduce unnecessary interventions.

[The territorial expression of health-service planning: scenarios for shared decision-making on the development and adaptation of services on a territorial level].

To apply planning criteria on a territorial level, with a forward-looking approach and taking into account the specificities of each location, in the Health Map of Catalonia, scenarios have been constructed for the development and adaptation of services for the 2015 horizon. The territorial scale is that of the 37 areas into which Catalonia has been divided in order to promote a new form of decentralised, combined decision- making, through the Territorial Health Governments. The new territorial health organisation is the substrate which must enable the relationship between professionals and services that share the same reference population to be coordinated.

[Planning criteria based on types of health, social health and public healthcare services: trends in the development and adaptation of services and healthcare integration].

This article points out the trends established by the Health Map of Catalonia for types of services (primary healthcare, specialised acute care, mental health care, social healthcare, emergency care and home healthcare). The drawing up of planning criteria for the 2015 horizon includes the identification of a strategic vision for the healthcare model, the revision of healthcare processes and the adaptation to demand, the estimation of the health care capacity required and the proposal of territorial coverage objectives. Also included are planning guidelines for health services, in the context of ongoing change.

[Strategic lines for the guidance of health services with a future perspective].

The Health Map of Catalonia includes a set of strategic lines which constitute a framework for the alignment of objectives in the public healthcare system and which are elements of guidance in the evolution of the healthcare model with regard to the future. The strategic lines are grouped into 10 major themes which deal with the health policy and service policy (priorities and objectives of the system); the role of the citizens as protagonists; interaction between professionals and patients; comprehensive care and continuity in healthcare; collaboration between teams of professionals in multi-centre networks; professional development; information and communication technologies aiding in clinical decisions and relationships between professionals; the triumvirate of accessibility, quality and efficiency; the participation of citizens, institutions, professionals and organisations in the operation of services; and, finally, the assessment, to give an account of the above and take action.

[The incorporation of the views of the public, professionals and managers in the healthcare planning process in Catalonia, Spain].

The views of those populations that interact every day in the heart of the health system: the public, professionals and managers have now been added to the traditional technical-political approach to healthcare planning. This article presents the methodology of and a selection of results from a study carried out for the Health Map of Catalonia using qualitative methods (individual interviews, focus groups and biographical accounts) with 254 participants. The results highlight aspects related with, among others, resources (structural and informal), work overload, overuse, over-medicalisation, definition of processes, the time variable, coordination, the knowledge and competence of professionals, the conditions and key perspectives of healthcare practice (of both professionals and users), and the role of intermediary played by the professional in the system.

[Health map: a dynamic vision of health service planning in Catalonia, Spain].

In 2004 a political boost was given to healthcare planning and assessment in Catalonia with the aim of channelling public funds more efficiently towards the health of the citizens and the quality of the system. Health planning is carried out from the central and regional structures of the Department of Health and is implemented by means of planning instruments. The Health, Social Health and Public Healthcare Map is the new service-planning instrument.

[Public healthcare coverage versus double healthcare coverage: what are the differences?].

Objective: To identify differences in socioeconomic characteristics, health status, health services' utilization, and satisfaction with health services between the population with public healthcare coverage only and the population with double healthcare coverage through additional affiliation to mutual or private health insurance companies.

Methods: Data from the 2002 Catalan Health Interview Survey with interviews to 8,400 individuals were used. Individuals with public healthcare insurance were differentiated from those who also had private health insurance.