Healthcare costs of Dutch residents with basic insurance (01-01-2009-01-01-2015)

This file contains per Dutch resident, who is insured through the basic insurance, his costs per year for care insured through the basic insurance. The basic insurance is legally required through the Health Insurance Act (Zvw) for almost all Dutch residents. The costs are those that have actually been reimbursed by the health insurers.The costs are divided into forms of care, such as GP care, hospital care, physiotherapy, etc. The healthcare costs include the costs that are ultimately paid by the insured themselves due to the mandatory or voluntary deductible, but excluding own payments. If the insured has received an account himself and has not submitted it to the insurance, for example because the deductible has not been reached, the costs are not included in the figures. The use of this file requires permission from the data provider. This permission can be obtained by sending an e-mail with the analysis plan or the quotation to the Centre for Policy Statistics: [mail address hidden – contact CBS]. The Centre for Policy Statistics will then contact the data supplier for arranging consent. More information on how to access the data: > https://www.cbs.nl/nl-nl/onze-diensten/maatwerk-en-microdata/microdata-zelf-onderzoek-doen ### Methodology The raw data on actual reimbursed expenses associated with the basic insurance relating to a reporting year originates from Vektis, who in turn receives this information from the health insurers. Not to be taken into account: (1) care for which one can insure themselves through supplementary insurance, (2) care costs that fall outside the Health Insurance Act (Zvw) and have been paid through own payments and (3) care that falls under another legal framework (such as (until 2014) the General Act on Special Medical Expenses; AWBZ, from 2015 the Long-term Care Act and the Youth Act, etc). Up to the reporting year 2010, the costs are observed during the year itself and the following three quarters, from 2011 during the year itself and the following four quarters. In seven quarters, approximately 95 % of all declarations within that reporting year are reported, with hospital care and mental health care in particular not yet fully received. The remaining costs for these two forms of care exceed the mentioned 5 %. When observed over 8 quarters, about 98 % of all declarations are in. The health insurers have made an estimate of the remaining costs that they still expect to receive. With the help of this estimate, Vektis increased the costs per health insurer per healthcare form; these increased costs are included in this file. The actual costs are not available separately. An important point of attention is that only the costs are increased for those who already had costs, whereas in reality this does not have to be the case. It is therefore not possible to determine the exact number of people who have actually received care. The health insurers can be divided into risk bearers and proxy holders. The risk bearers are the "real & quot; health insurers and bear the financial risk associated with insuring a person. The proxy holders do take out basic insurance, but do so on behalf of one or more risk bearers. Attorneys do not bear the risk themselves. The proxy holders are aware that the cost data they provide are less reliable. They also provide the identifying data of individuals, which makes it possible to identify the population insured through them. The data of these persons are not used for the calculations for the StatLine tables. Therefore, the persons insured by a proxy holder have been raised. This was done on the basis of the following personal characteristics: age, gender, origin grouping, household income and GGD region. The insured persons through a proxy holder are included in the file. However, these have a higher factor of &0 ' got it. The resulting elevation factors are in the variable ZVWKOPHOOGFACTOR. ### Population Dutch residents who actually have basic insurance.本数据集涵盖所有参保基础健康保险的荷兰居民的年度基础医保覆盖医疗费用明细。荷兰绝大多数居民均需依据《健康保险法》（Health Insurance Act, Zvw）参保基础健康保险。本次统计的费用为健康保险公司实际已赔付的金额，费用按医疗服务类型分类，例如全科诊疗、住院治疗、物理治疗等。 医疗费用包含参保人因强制或自愿免赔额最终自付的部分，但不含个人自费支出。若参保人自行收到账单却未向保险公司提交申报（例如未达到免赔额门槛），此类费用不计入本数据集统计数值。 使用本数据集需获得数据提供方的授权。申请人可通过发送包含分析方案或报价的邮件至政策统计中心（Centre for Policy Statistics，联系方式：[邮箱已隐藏，请联系荷兰中央统计局（CBS）]）获取授权，该中心将协助联系数据供应商完成许可手续。 更多数据获取相关信息，请访问： > https://www.cbs.nl/nl-nl/onze-diensten/maatwerk-en-microdata/microdata-zelf-onderzoek-doen ### 研究方法 与报告年度基础健康保险相关的实际赔付费用原始数据来源于Vektis，该机构的信息来源为各健康保险公司。以下费用不计入统计范围：(1) 可通过补充健康保险覆盖的医疗服务；(2) 不属于《健康保险法》（Zvw）范畴且由个人自费支付的医疗费用；(3) 受其他法律框架监管的医疗服务（例如2014年之前的《特殊医疗费用通用法案》（General Act on Special Medical Expenses, AWBZ），2015年起的《长期护理法》与《青年福利法》等）。 截至2010年报告年度，费用统计周期为报告年度当年及后续三个季度；2011年起，统计周期调整为报告年度当年及后续四个季度。在统计周期的前七个季度内，可覆盖该报告年度约95%的申报费用，其中住院治疗与精神卫生医疗的申报覆盖率尤为不足，这两类医疗服务的剩余未申报费用占比超过前述5%。若将统计周期延长至八个季度，则可覆盖约98%的申报费用。健康保险公司会对后续仍将到账的剩余费用进行估算，Vektis据此按健康保险公司与医疗服务类型分别调整费用金额，调整后的费用已纳入本数据集，原始实际费用无法单独获取。需注意的是，本次调整仅针对已有费用记录的参保人，而实际情况未必如此，因此无法准确统计实际接受医疗服务的参保人数。 健康保险公司可分为风险承担方与代理机构两类。风险承担方为“实质”健康保险公司，承担参保人的保险相关财务风险；代理机构虽参保基础健康保险，但仅代表一家或多家风险承担方开展业务，自身不承担保险风险。代理机构知晓其提供的费用数据可靠性较低，且其提交的个人身份信息可用于识别其所承保的参保群体，但此类群体的相关数据未用于StatLine统计表格的计算。因此，需对代理机构承保的参保人群数据进行加权调整，调整依据包括年龄、性别、原籍群体、家庭收入以及GGD区域。代理机构承保的参保人员仍被纳入本数据集，最终生成的加权系数存储于变量ZVWKOPHOOGFACTOR中。 ### 研究对象 研究对象为实际参保基础健康保险的荷兰居民。