Senior Health Services Researcher

Head of the unit for Health Services and Policy Research
Institute for Health Sciences IACS - IIS Aragon

13th San Juan Bosco, CIBA building
50009 Zaragoza , Spain

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Curriculum vitae



• Medical Doctor, Public Health and Preventive Medicine

• Doctorate studies in Sociology, PhD grade in Medicine

• Master in Health Economics


Main ongoing projects



• Variations in Medical Practice in the Spanish National Health System


• ECHO project, Unwarranted Variations in Systems Performance in Europe


• Health Systems and Policy Monitor - European Observatory on Health Systems and Policies


• REDISECC – Spanish Network for Health Services Research in Chronic Care


• CHRODIS JA – Joint Action on Chronic Diseases



Other current merits

• Editor-in-Chief Atlas of Variations in Medical Practice in the National Health System


• Associate Editor BMC Health Services Research


• Section Editor Archives of Public Health


• Member of the Wennberg International Collaborative


• Former President of the Spanish Health Economics Association (AES)



Selected publications

Ibañez-Beroiz B, Librero J, Martinez-Lizaga N, Peiró S, Bernal-Delgado E. Applying Spation-Temporal Models to Assess Variations across Health Care Areas and Regions: Lessons from the Decentralized Spanish National Health System. Plos One 2017 Feb 6;12(2):e0170480. doi:10.1371/journal.pone.0170480. eCollection 2017.


Angulo-Pueyo E, García-Armesto S, Martínez-Lizaga N, Ridao-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 Feb 24;7(2):e011844. doi: 10.1136/bmjopen-2016-011844.


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 Apr;52(2):863-878. doi:10.1111/1475-6773.12508


Librero J, Peiró S, Ibañez-Beroiz B, Ridao-López M, Rodríguez-Bernal CL, Bernal-Delgado E. Trends and area variations in Potentially Preventable Admissions for COPD in Spain (2002-2013): a significant decline and convergence between area. BMC Health Serv Res. 2016; 16: 367.


Auffray C, Balling R, Barroso I, Bencze L, Benson M, Bergeron J, Bernal-Delgado E, et al Making sense of big data in health research: Towards an EU action plan. Genome Med. 2016 Jun 23;8(1):71. doi: 10.1186/s13073-016-0323-y.


Bernal-Delgado E, Ridao-Lopez M, Garcia-Armesto S (in press). Medical Practice Variations in Elective Surgery. In: Sobolev B (Series ed), Johnson A, Stukel T (eds). Health Services Research Series. Medical Practice Variations. Springer, New York.


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. Eur J Public Health. 2015 Feb;25 Suppl 1:3-7.


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. Eur J Public Health. 2015 Feb;25 Suppl 1:8-14.


Cookson R, Gutacker N, Garcia-Armesto S, Angulo-Pueyo E, Christiansen T, Bloor K, Bernal-Delgado E. Socioeconomic inequality in hip replacement in four European countries from 2002 to 2009-area-level analysis of hospital data. Eur J Public Health. 2015 Feb;25Suppl 1:21-7.


Gutacker N, Bloor K, Cookson R, Garcia-Armesto S, Bernal-Delgado E. Comparing hospital performance within and across countries: an illustrative study of coronary artery bypass graft surgery in England and Spain. Eur J Public Health. 2015 Feb;25 Suppl 1:28-34


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. Eur J Public Health. 2015 Feb;25 Suppl 1:35-43


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 Feb;25 Suppl 1:44-51.


Ibañez-Beroiz B, Librero L, Bernal-Delgado E, García-Armesto S, Villanueva-Ferragud S, Peiró S. Joint spatial modelling to identify shared patterns among chronic related potentially preventable hospitalizations. BMC Medical Research Methodology 2014, 14:74.


Bernal-Delgado E, García-Armesto S, Peiró S on behalf of the Atlas VPM group. Atlas of Variations in Medical Practice: the Spanish National Health Service under scrutiny. Health Policy 2014; 114(1): 15-30


García-Armesto S, Campillo-Artero C, Bernal-Delgado E. Disinvestment in the age of cost-cutting sound and fury. Tools for the Spanish National Health System. Health Policy 2013; 10(2-3): 180-5.


Bernal-Delgado E, García-Armesto S, Martínez-Lizaga N, Beltrán-Peribañez J, Peiró-Moreno S. Should Policy-makers and managers trust PSI? An empirical validation study of Five Patient Safety Indicators in a National Health Service. BMC Medical Research Methodology 2012; 12:19


Librero J, Peiró S, Leutscher E, Merlo J, Bernal-Delgado E, Ridao M, Martínez N Sanfélix-Gimeno G Timing of surgery for hip fracture and in-hospital mortality. A retrospective population-based cohort study in the Spanish National Health System. BMC Health Services Research 2012; 12:15


Ibañez B, Librero J, Peiró 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 Methods in Medical Research 2011; 11:172.


Ridao-López M, García-Armesto S, Abadía-Taira MB, Peiró-Moreno S, Bernal-Delgado E Income Level and Regional Policies, Underlying Factors Associated With Unwarranted Variations in Conservative Breast Cancer Surgery in Spain. BMC Cancer 2011, 11:145.


Bernal-Delgado E, Martos C, Martinez N, Chirlaque MD, Márquez M, Navarro C et al. Is hospital discharge administrative data an appropriate source of information for cancer registries purposes? Some insights from four Spanish Registries. BMC Health Serv Res. 2010; 10:9.


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 Serv Res. 2009; 9:60.



Last update: 03/May/2017














Proyecto ECHO- www.echo-health.eu




Dónde estamos




Atlas VPM - Atlas de Variaciones de la Práctica Médica

Instituto Aragonés de Ciencias de la Salud- I+CS

Edificio CIBA
Avda. San Juan Bosco, 13
50009 Zaragoza
T.: 976. 71.6837/ 5483
F.: 976.71.4670