Inter-Regime Health Insurance Expenses in France (DAMIR)

This dataset is an extraction from the National Inter-Regime Health Insurance System (SNIIRAM) covering all health insurance reimbursements across all regimes in France between 2009 and 2021.

In order to preserve the anonymity of healthcare professionals and patients, the geographical axes are limited:
- to 9 geographical zones (study and territorial planning zones) which are groupings of administrative regions from 2009 to 2014, refered to as ZEAT (Zone d'Emploi à Agglomération de Taille intermédiaire) which means the Intermediate-sized Agglomeration Employment Zone.
- to 13 geographical zones (close to the newly created large administrative regions) from 2015 onwards, refered to as REG for Region.

Expenses are detailed according to six analytical axes (period, service, payer organization, care beneficiary, performing healthcare professional, prescribing healthcare professional) and seven amount (total expense, reimbursement basis, amount reimbursed, excess) and volume (number, quantity, coefficient) indicators. In total, each service line is described by 55 variables. It is essential to refer to the dataset description accompanying the data.

This database consists of 12 tables whose names are prefixed with "A" and suffixed with the year and month of expense reimbursement. The 55 varibales contained in these tables are :

• AGE_BEN_SNDS: Age group of the beneficiary at the time of care
• ASU_NAT: Type of insurance coverage
• ATT_NAT: Nature of the work accident
• BEN_CMU_TOP: Top CMU-C beneficiary
• BEN_QLT_COD: Quality of the beneficiary
• BEN_RES_REG: Region of residence of the beneficiary from 2015 (A tables)
• BEN_RES_ZEAT: Residence ZEAT of the beneficiary until 2014 (P tables)
• BEN_SEX_COD: Gender of the beneficiary
• CPL_COD: Additional procedure
• CPT_ENV_TYP: Type of envelope
• DDP_SPE_COD: Discipline of the executing institution's service
• DRG_AFF_NAT: Nature of the recipient of the refined payment
• ETE_CAT_SNDS: Category of the executing institution
• ETE_IND_TAA: TAA indicator private/public of the executing institution
• ETE_REG_COD: Region of implementation of the executing institution from 2015 (A tables)
• ETE_ZEAT_COD: Executing Institution's Implantation ZEAT until 2014 (P tables)
• ETE_TYP_SNDS: Type of executing institution
• ETP_CAT_SNDS: Category of the prescribing institution
• ETP_REG_COD: Region of implementation of the prescribing institution from 2015 (A tables)
• ETP_ZEAT_COD: Prescribing Institution's Implantation ZEAT until 2014 (P tables)
• EXE_INS_REG: Region of the executing healthcare professional from 2015 (A tables)
• EXE_INS_ZEAT: ZEAT of the Executing Health Professional until 2014 (P tables)
• EXO_MTF: Reason for exemption from the moderation fee
• FLT_ACT_COG: Global coefficient of the pre-filtered service
• FLT_ACT_NBR: Enumeration of the pre-filtered service
• FLT_ACT_QTE: Quantity of the pre-filtered service
• FLT_DEP_MNT: Amount of the pre-filtered service exceeding the limit
• FLT_PAI_MNT: Amount of expenditure for the pre-filtered service
• FLT_REM_MNT: Pre-filtered amount paid/refunded
• FLX_ANN_MOI: Year and month of processing
• MDT_TYP_COD: Treatment mode of the executing institution
• MFT_COD: Tariff fixation mode of the executing institution
• MTM_NAT: Modulation of the moderation fee
• ORG_CLE_REG: Region of the liquidation agency from 2015 (A tables)
• ORG_CLE_ZEAT: ZEAT of the Payment Organization until 2014 (P tables)
• PRE_INS_REG: Region of the prescribing healthcare professional from 2015 onwards (A tables)
• PRE_INS_ZEAT: Zonal Establishment for Administrative and Technical Services of the prescribing healthcare professional until 2014 (P tables)
• PRS_ACT_COG: Global coefficient for the healthcare service or treatment provided
• PRS_ACT_NBR: Number of healthcare services or treatments provided
• PRS_ACT_QTE: Quantity of healthcare service or treatment provided
• PRS_DEP_MNT: Amount of the healthcare service or treatment exceeding the reimbursement limit
• PRS_FJH_TYP: Type of flat-rate daily hospitalization fee
• PRS_NAT: Nature of the healthcare service or treatment provided
• PRS_PAI_MNT: Amount of the healthcare expense paid
• PRS_PDS_QCP: Qualifying code for the healthcare pathway
• PRS_PPU_SEC: Code for private or public healthcare sector
• PRS_REM_BSE: Base amount for healthcare reimbursement
• PRS_REM_MNT: Amount of healthcare expenses reimbursed
• PRS_REM_TAU: Rate of healthcare reimbursement
• PRS_REM_TYP: Type of healthcare reimbursement
• PSE_ACT_CAT: Category of the healthcare professional providing the service
• PSE_ACT_SNDS: Nature of the healthcare activity of the healthcare professional providing the service
• PSE_SPE_SNDS: Medical specialty of the healthcare professional providing the service
• PSE_STJ_SNDS: Legal status of the healthcare professional providing the service
• PSP_ACT_CAT: Category of the prescribing healthcare professional
• PSP_ACT_SNDS: Nature of the healthcare activity of the prescribing healthcare professional
• PSP_SPE_SNDS: Medical specialty of the prescribing healthcare professional
• PSP_STJ_SNDS: Legal status of the prescribing healthcare professional
• TOP_PS5_TRG: Top perimeter excluding CMU-C and information services

The database also includes a table named "descriptif" that describes and indicates the label of the 55 variables contained in the tables.