POPULATION AND SETTING
The autonomous community of Catalonia has its own national health system. Primary Care is organized in 370 Primary Care Teams (PCT), which consist of a variable number of GPs, nurses, paediatricians, social workers, dentists and non-clinical support staff. Each resident of Catalonia is allocated a doctor and a nurse in a PCT. In any given year, 76% of the population attends at least once the PCT.
The Catalan Institute of Health (CIH) is the main provider of health services in Catalonia. The CIH manages 279 PCT with a catchment of 5.564.292 people, approximately 74% of the Catalan population.
The over 9,175 professionals of primary care of the CIH (over 3,384 GPs) use the same programme of electronic medical records called ECAP. The implementation of the programme started in 1998 in some PCT, and since 2005 it is standard use in all visits in every PCT of the CIH.
For all 5.8 million patients of the CIH, Primary Care teams, the SIDIAP has available the following information linked to a unique and anonymus identifier:1
Information originated from the medical records ECAP: All registered data since the programme started are available. For each person we have:
- Demogrpahic data: Date of birth, gender, nationality, allocated PCT and professionals, MEDEA index
- Visits to Primary Care Service: Date, type and professional in charge
- Health Problems : ICD-10 code, date of diagnosis and expiry date. Available for acute and chronic health problems
- Clinical variables : Date and measurement. Clinical variables available are, for instance, blood pressure, smoking habit and BMI
- Immunitsations: Vaccine administered and date
- Referrals: Date and department of referral
- Death: Date of death
- Sick leave: Date and ICD-10 diagnosis
Information on laboraoty results: Since 2006, information is available on the results of laboratory analysis requested by PCT of the CIH. This information is obtained directly from the databases of the laboratories and therefore does not depend on the manual register of the professionals in the PCT. Validation and standardization of protocols to guarantee data quality.3
Information on medication dispensed in pharmacies: Since 2005, information is available on all pharmaceutical products with a prescription of the national health system signed by a professional of the Catalan Institute of Health and dispensed in pharmacies. This information is directly obtained from the joint database of CatSalut with Catalan pharmacies.4
Other external sources: In addition and according to the needs of each project, SIDIAP allows linking with other databases of Catalonia at an individual level through a mechanism that guarantees the confidentiality of the clinical data. Some of these databases are:
- CMBD-AH (CatSalut): Dates and diagnostics and procedures (ICD-9 Codes) linked to admissions in every hospital of Catalonia.
- Mortality (Health Departament ): Date and causes of death of all residents of Catalonia.
- Other: Population registers of cancer, arthroplasty, renal transplant, dialysis, etc. .