Journal Articles


Enrique Bernal-Delgado, Micaela Comendeiro-Maaløe, Manuel Ridao-López et. al. Factors underlying the growth of hospital expenditure in Spain in a period of unexpected economic shocks: A dynamic analysis on administrative data. Health Policy. 2020.


Comendeiro-Maaløe M, Ridao-López M, Gorgemans S, Bernal-Delgado E. Public-private partnerships in the Spanish National Health System: The reversion of the Alzira model. Health Policy. 2019.

Catalá-López F, Ridao M, Bernal-Delgado E, Moher D, Repullo JR. Endorsement of guidelines for reporting economic evaluation studies by Spanish biomedical journals. Gaceta Sanitaria. 2019.

Tanke MAC, Feyman Y, Bernal-Delgado E, Deeny SR, Imanaka Y, Jeurissen P, Lange L, Pimperl A, Sasaki N, Schull M, Wammes JJG, Wodchis WP, Meyer GS. A challenge to all. A primer on inter-country differences of high-need, high-cost patients. PLoS One. 2019.


Enrique Bernal-Delgado, Sandra Garcia-Armesto, Juan Oliva et. al. Spain: Health System Review. Health Systems in Transition. 2018.

Comendeiro-Maaløe M, Ridao-López M, Gorgemans S, Bernal-Delgado E. A comparative performance analysis of a renowned public private partnership for health care provision in Spain between 2003 and 2015. Health Policy. 2019.

Ridao-López M, Comendeiro-Maaløe M, Martínez-Lizaga N, Bernal-Delgado E. Evolution of public hospitals expenditure by healthcare area in the Spanish National Health System: the determinants to pay attention to. BMC Health Services Research. 2018.

Gorgemans S, Comendeiro-Maaløe M, Ridao-López M, Bernal-Delgado E. Quality and technical efficiency do not evolve hand in hand in Spanish hospitals: Observational study with administrative data. PLoS One. 2018.


Librero, J., Ibanez-Beroiz, B., Peiro, S. Trends and area variations in Potentially Preventable Admissions for COPD in Spain (2002-2013): a significant decline and convergence between areas. BMC Health Services Research. 2017

Hernandez Miguel, M. V., Martin Martinez, M. A., Corominas, H. et a. Variability in Rheumatology day care hospitals in Spain: VALORA study. Reumatologica Clinica. 2017.

Espallardo, O., Busutil, R., Torres, A., et al. The Impact of Severe Obesity on Healthcare Resource Utilisation in Spain. Obes Surg. 2017

Ibañez-Beroiz B, Librero J, Martinez-Lizaga N, Peiró S, Bernal-Delgado E. Applying Spatio-Temporal Models to Assess Variations across Health Care Areas and Regions: Lessons from the Decentralized Spanish National Health System. Plos One. 2017.

Angulo-Pueyo E, García-Armesto S, Martínez-Lizaga N, Riado-López M, Peiró S, Bernal-Delgado E. Factors associated with hospitalisations in chronic conditions deemed avoidable: ecological study in the Spanish health care system. BMJ Open. 2017.

Gutacker N, Bloor K, Cookson R, Gale CP, Maynard A, Pagano D, Pomar J Bernal-Delgado E. Hospital surgical volumes and mortality after coronary artery bypass grafting: using international comparisons to determine a safe threshold. Health Services Research. 2017.


Perez-Romero, S., Gascon-Canovas, J. J., Salmeron-Martinez, D. et al. Sociodemographic characteristics and geographic variability associated with patient satisfaction in Primary Care. Rev Calid Asist. 2016.

Librero J, Peiró S, Ibañez-Beroiz B, et al Trends and area variations in Potentially Preventable Admissions for COPD in Spain (2002-2013): a significant decline and convergence between areas.  BMC Health Services Research. 2016.


Bernal-Delgado E, Christiansen T, Bloor K, Mateus C, Yazbeck AM, Munck J, Bremner J; ECHO Consortium. ECHO: health care performance assessment in several European health systems. European Journal of Public Health. 2015.

Thygesen LC, Baixauli-Pérez C, Librero-López J, Martínez-Lizaga N, Ridao-López M, Bernal-Delgado E; ECHO Consortium. Comparing variation across European countries: building geographical areas to provide sounder estimates. European Journal of Public Health. 2015.

Cookson R, Gutacker N, Garcia-Armesto S, et al. Socioeconomic inequality in hip replacement in four European countries from 2002 to 2009-area-level analysis of hospital data. European Journal of Public Health. 2015.

Gutacker N, Bloor K, Cookson R, et al. Comparing hospital performance within and across countries: an illustrative study of coronary artery bypass graft surgery in England and Spain. European Journal of Public Health. 2015.

Thygesen LC, Christiansen T, Garcia-Armesto S, Angulo-Pueyo E, Martínez-Lizaga N, Bernal-Delgado E; ECHO Consortium. Potentially avoidable hospitalizations in five European countries in 2009 and time trends from 2002 to 2009 based on administrative data. European Journal of Public Health. 2015.

García-Armesto S, Angulo-Pueyo E, Martínez-Lizaga N, Mateus C, Joaquim I, Bernal-Delgado E; ECHO Consortium. Potential of geographical variation analysis for realigning providers to value-based care. ECHO case study on lower-value indications of C-section in five European countries. Eur J Public Health. 2015.

Salinas M, Lopez-Garrigos M, Flores E, Uris J, Leiva-Salinas C. Larger differences in utilization of rarely requested tests in primary care in Spain. Biochemedical Medine. 2015.

Miravitlles M, Huerta A, Valle M, et al. Clinical variables impacting on the estimation of utilities in chronic obstructive pulmonary disease. International Journal of Chronic Obstructive Pulmonary Disease. 2015.


Bernal-Delgado E, Garcia-Armesto S, Peiro S, Atlas VPMG. Atlas of Variations in Medical Practice in Spain: the Spanish National Health Service under scrutiny. Health Policy. 2014.

Ibañez-Beroiz B, Librero J, Bernal-Delgado E, García-Armesto S, Villanueva-Ferragud S, Peiró S. Joint spatial modeling to identify shared patterns among chronic related potentially preventable hospitalizations. BMC Medical Research Methodology. 2014.


Alonso-Babarro A, Astray-Mochales J, Dominguez-Berjon F, et al. The association between in-patient death, utilization of hospital resources and availability of palliative home care for cancer patients. Palliative Medicine. 2013.

Padilla-Eguiluz NG, García-Rey E, Cordero-Ampuero J, Gómez-Barrena E. Regional variability in the rates of total hip replacement in Spain. Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy. 2013.


Aizpuru F, Latorre A, Ibáñez B, et al. Variability in the detection and monitoring of chronic patients in primary care according to what is registered in the electronic health record. Family Practice. 2012.


Ibanez-Beroiz B, Librero-Lopez J, Peiro-Moreno S, Bernal-Delgado E. Shared component modelling as an alternative to assess geographical variations in medical practice: gender inequalities in hospital admissions for chronic diseases. BMC Medical Research Methodology. 2011.

Llorente C, Blasco JA, Quintana JM, et al. Interhospital variation in appropriateness of cataract surgery. Journal of Evaluation in Clinical Practice. 2011.

Ridao-Lopez, Manuel. Garcia-Armesto, Sandra. Abadia-Taira, Begona. Peiro-Moreno, Salvador. Bernal-Delgado, Enrique. Income level and regional policies, underlying factors associated with unwarranted variations in conservative breast cancer surgery in Spain. BMC Cancer. 2011.


Garrido-Cumbrera M, Borrell C, Palencia L, et al. Social class inequalities in the utilization of health care and preventive services in Spain, a country with a national health system. International Journal of Health Services. 2010.


Ibáñez B, Librero J, Bernal-Delgado E, Peiró S, López-Valcarcel BG, Martínez N, Aizpuru F. Is there much variation in variation? Revisiting statistics of small area variation in health services research. BMC Health Services Research. 2009.


Magan P, Otero A, Alberquilla A, Ribera JM, Magan P, Otero A, et al. Geographic variations in avoidable hospitalizations in the elderly, in a health system with universal coverage. BMC Health Services Research. 2008.

Román R, Comas M, Mar J, Bernal E, Jiménez-Puente A, Gutiérrez-Moreno S, Castells X; IRYSS Network Modelling Group. Geographical variations in the benefit of applying a prioritization system for cataract surgery in different regions of Spain. BMC Health Services Research. 2008.


Atlas VPM

Atlas VPM

Echo (European Collaboration for Healthcare Optimization)


Atlas on Potentially Avoidable Hospitalizations in Chronic Care (2019)

Atlas on Hospitalizations for Coronary Ischemic Disease and Cardiac Procedure (2019)

Atlas for Monitoring Diabetes Care (2019)

Atlas on Orthopaedic (2017)

Atlas on Lower Value Care (2017)

Atlas on Potentially Avoidable Hospitalizations in Chronic Conditions: 2015 Update, differences between sexes and age groups (2017)

Atlas on Cardiovascular, Lower Value Care, Potencially Avoidable Hospitalizations, Orthopaedic Care in European Countries (Spain, Denmark and Slovenia) (2014)