Open Access Open Badges Research article

Evaluation of an integrated system for classification, assessment and comparison of services for long-term care in Europe: the eDESDE-LTC study

Luis Salvador-Carulla12*, Javier Alvarez-Galvez3, Cristina Romero2, Mencia R Gutiérrez-Colosía2, Germain Weber4, David McDaid5, Hristo Dimitrov6, Lilijana Sprah7, Birgitte Kalseth8, Giuseppe Tibaldi9, Jose A Salinas-Perez3, Carolina Lagares-Franco11, Maria Teresa Romá-Ferri12 and Sonia Johnson10

Author affiliations

1 Centre for Disability Research and Policy Faculty of Health Sciences, University of Sydney, 75 East St Lidcombe, Sydney, NSW 2141, Australia

2 Scientific Association PSICOST, Cadiz, Jerez de la Frontera, Spain

3 Área de Salud y Política Social, Universidad Loyola Andalucía, Seville, Spain

4 Center for Teaching and Learning, University of Vienna, Vienna, Austria

5 LSE Health and Social Care, London School of Economics and Political Sciences, London, UK

6 Public Health Association, Sofia, Bulgaria

7 Sociomedical Institute, Scientific Research Centre of the Slovenian Academy of Sciences and Arts, Ljubljana, Slovenia

8 Department of Health Research, SINTEF Technology and Society, Trondheim, Norway

9 Centro Studi e Ricerche in Psichiatria ASLT02, Torino, Italy

10 Mental Health Sciences Unit, University College London, London, UK

11 Área de Estadística e Investigación Operativa, Universidad de Cádiz, Cádiz, Spain

12 Departamento de Enfermería, Universidad de Alicante, Alicante, Spain

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Citation and License

BMC Health Services Research 2013, 13:218  doi:10.1186/1472-6963-13-218

Published: 15 June 2013



The harmonization of European health systems brings with it a need for tools to allow the standardized collection of information about medical care. A common coding system and standards for the description of services are needed to allow local data to be incorporated into evidence-informed policy, and to permit equity and mobility to be assessed. The aim of this project has been to design such a classification and a related tool for the coding of services for Long Term Care (DESDE-LTC), based on the European Service Mapping Schedule (ESMS).


The development of DESDE-LTC followed an iterative process using nominal groups in 6 European countries. 54 researchers and stakeholders in health and social services contributed to this process. In order to classify services, we use the minimal organization unit or “Basic Stable Input of Care” (BSIC), coded by its principal function or “Main Type of Care” (MTC). The evaluation of the tool included an analysis of feasibility, consistency, ontology, inter-rater reliability, Boolean Factor Analysis, and a preliminary impact analysis (screening, scoping and appraisal).


DESDE-LTC includes an alpha-numerical coding system, a glossary and an assessment instrument for mapping and counting LTC. It shows high feasibility, consistency, inter-rater reliability and face, content and construct validity. DESDE-LTC is ontologically consistent. It is regarded by experts as useful and relevant for evidence-informed decision making.


DESDE-LTC contributes to establishing a common terminology, taxonomy and coding of LTC services in a European context, and a standard procedure for data collection and international comparison.

Health service research; Health system research; Healthcare terminology; Healthcare taxonom; Healthcare instrument