NHIF Inpatient Hospitalisation Cases by Clinical Pathway, Diagnosis Pair, Facility, and Regional Health Insurance Fund — Bulgaria

This dataset contains monthly administrative records of inpatient hospitalisation cases reimbursed by the National Health Insurance Fund of Bulgaria (Национална здравноосигурителна каса, НЗОК/NHIF) under the clinical pathway (КП), ambulatory procedure (АПр), and clinical procedure (КПр) reimbursement framework. The data were obtained through the NHIF's publicly accessible monthly statistical reporting system and cover the period January 2024 through December 2025, comprising 24 monthly files aggregated into a single analytical dataset. Each record represents a unique combination of reporting month, Regional Health Insurance Fund (РЗОК) office, contracted medical facility, reimbursement pathway code, primary diagnosis (ICD-10), and secondary (comorbid) diagnosis (ICD-10), with corresponding counts of reported cases and distinct insured persons. The dataset contains 2,479,646 rows and 11 variables, covering all 28 RHIF regions, 499 contracted facilities, and 591 distinct pathway codes, with a total of 8,531,248 reported cases and 6,723,514 insured persons across the observation period. The raw monthly XLSX files were processed using R (version 4.5.1; tidyverse, readxl) with a standardised pipeline that harmonised column names to English and R-compatible identifiers, parsed RHIF numeric codes and region names from the combined source field, enforced ICD-10 coding as character strings, and derived temporal identifiers (year, month, year_month) from filenames. No records were imputed, modified, or excluded beyond removal of structurally empty trailing rows present in the source exports. The companion metadata file (nhif_hospitalisation_combined_metadata.csv) provides a full data dictionary with English and Bulgarian descriptions, source column mappings, data types, and value formats for all 11 variables. This dataset is intended to support epidemiological burden-of-disease analyses, health technology assessment, health economic modelling, and health policy research in the Bulgarian context. It is particularly suited to analyses requiring longitudinal inpatient activity data stratified by diagnosis pair, reimbursement pathway, facility, and geographic region. Researchers should note that the unit of observation is an administrative reimbursement record, not an individual patient episode; the n_cases and n_insured fields may differ within a record where a single insured person had multiple reimbursed episodes within the same month under the same pathway and diagnosis combination. Data Dictionary Variable Type Description (EN) Description (BG) Source field Values / Format year_month Date First day of the reference month Първи ден на отчетния месец filename YYYY-MM-DD year integer Calendar year of the reference period Календарна година на отчетния период filename e.g. 2024 month integer Calendar month of the reference period Календарен месец на отчетния период filename 1–12 rhif_code integer Numeric code of the Regional Health Insurance Fund Числов код на РЗОК РЗОК (first token) 1–28 rhif_name character Name of the Regional Health Insurance Fund Наименование на РЗОК РЗОК (remainder) e.g. Благоевград facility_name character Name of the contracted healthcare facility Наименование на лечебното заведение Име ЛЗБП free text pathway_code character Clinical pathway, ambulatory procedure, or clinical procedure code Код на КП / АПр / КПр КП/АПр/КПр alphanumeric NHIF code diagnosis_primary character Primary diagnosis (ICD-10 code) Основна диагноза (МКБ-10) Основна диагноза ICD-10 e.g. H25.1 diagnosis_secondary character Secondary (comorbid) diagnosis (ICD-10 code) Вторична диагноза (МКБ-10) Вторична диагноза ICD-10 e.g. I11.9 n_cases integer Number of hospitalisation cases reported Брой отчетени случаи Брой случаи non-negative integer n_insured integer Number of distinct insured persons (ЗОЛ) hospitalised Брой здравноосигурени лица Брой ЗОЛ non-negative integer Coverage summary Indicator Value Observation period January 2024 – December 2025 Number of months 24 Total rows 2,479,646 RHIF regions 28 Contracted facilities 499 Distinct pathway codes 591 Total cases 8,531,248 Total insured persons 6,723,514 Missing values 0 Files included nhif_hospitalisation_combined.csv — merged analytical dataset (UTF-8 with BOM) nhif_hospitalisation_combined_metadata.csv — variable-level data dictionary