Identification and location of hot and cold spots of treated prevalence of depression in Catalonia (Spain)

International Journal of Health Geographics

Luis Salvador-Carulla¹  Esther Jordà-Sampietro²  Cristina Molina-Parrilla²  Carlos R García-Alonso³  José A Salinas-Pérez³ 

[1] Faculty of Health Sciences, University of Sydney, Sydney, Australia;Direcció General de Regulació, Planificació i Recursos Sanitaris, Departament de Salut, Generalitat de Catalunya, Barcelona, Spain;Universidad Loyola Andalucía, Business Administration Faculty, Sevilla, Córdoba, Spain

关键词: Catalonia;    Depression;    Mental health;    Cold spots;    Hot spots;    Spatial analysis;   

Others  :  810877
DOI  :  10.1186/1476-072X-11-36

 received in 2012-06-08, accepted in 2012-08-10,  发布年份 2012

【 摘 要 】

Background

Spatial analysis is a relevant set of tools for studying the geographical distribution of diseases, although its methods and techniques for analysis may yield very different results. A new hybrid approach has been applied to the spatial analysis of treated prevalence of depression in Catalonia (Spain) according to the following descriptive hypotheses: 1) spatial clusters of treated prevalence of depression (hot and cold spots) exist and, 2) these clusters are related to the administrative divisions of mental health care (catchment areas) in this region.

Methods

In this ecological study, morbidity data per municipality have been extracted from the regional outpatient mental health database (CMBD-SMA) for the year 2009. The second level of analysis mapped small mental health catchment areas or groups of municipalities covered by a single mental health community centre. Spatial analysis has been performed using a Multi-Objective Evolutionary Algorithm (MOEA) which identified geographical clusters (hot spots and cold spots) of depression through the optimization of its treated prevalence. Catchment areas, where hot and cold spots are located, have been described by four domains: urbanicity, availability, accessibility and adequacy of provision of mental health care.

Results

MOEA has identified 6 hot spots and 4 cold spots of depression in Catalonia. Our results show a clear spatial pattern where one cold spot contributed to define the exact location, shape and borders of three hot spots. Analysing the corresponding domain values for the identified hot and cold spots no common pattern has been detected.

Conclusions

MOEA has effectively identified hot/cold spots of depression in Catalonia. However these hot/cold spots comprised municipalities from different catchment areas and we could not relate them to the administrative distribution of mental care in the region. By combining the analysis of hot/cold spots, a better statistical and operational-based visual representation of the geographical distribution is obtained. This technology may be incorporated into Decision Support Systems to enhance local evidence-informed policy in health system research.

【 授权许可】

   
2012 Salinas-Perez et al.; licensee BioMed Central Ltd.

【 图 表 】

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Figure 1 .

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