Closed Diagnosis Treatment Combination sub- trajectories in Medical Specialist Care (01-01-2015-01-01-2018)

This file is part of a set of files that relate to treatments within medical specialist care, such as these are registered in the DBC system and in other declarable care products. DBC stands for Diagnosis Treatment Combination. A DBC care product is a package of care with information about the diagnosis and treatment that a patient receives. These are mainly healthcare products that are described in the basic health insurance package. The care takes place in hospitals, independent treatment centres (ZBC and#039;s), categorical institutions for specific diseases and rehabilitation, dialysis, audiological and radiotherapeutic centres. The files are based on the data provided by the institutions to the DBC Information System (DIS), managed by the Dutch Healthcare Authority (NZa). These are files according to the renewed DBC system that started in 2012. From 1 January 2013, the specialty geriatric rehabilitation care has been added to the DBC system. There are 3 different files: a file with DBC sub- trajectories (MSZSub trajectoriesJJJTABVV), a file with the provided care profile (MSZSuppliedZorgprofileJJJTABVV) for a sub-route, and a file containing other care products (MSZOverigeZorgproductenJJJTABVV). In addition to the content files, a weight file (MSZUpweightsJJJ) is available to increase the number of open, ongoing and closed DBC sub-routes in a calendar year to edge totals according to a (more complete) declaration file of Vektis. The elevated weight for closed DBC sub-routes is also included in the MSZSub trajectoriesJJJTABVV file. When a patient comes to the medical specialist with a care request, the DBC registration opens a care process for this specific care question. One or more (serial) DBC sub-processes are part of a care process. A DBC sub-route (also known as DBC for short) is a part of a care pathway defined for declaration purposes and contains data such as duration, type of care, typical diagnosis and declaration data. As of 2015, the maximum duration of a DBC was 120 days; until 2015 it was 365 days. The basis of this dataset is the sub-route file that contains all DBC 's with a closing date in the reference year. The linked care profile file contains the care pathways and care activities associated with sub- trajectories with a closing date in the reference year. The care activities carried out in a sub-route relate to diagnostics, treatment, consultations, nursing days and/or (expensive) medicines. As of 2017, the declaration of expensive medicines has been changed. Add-ons for expensive medicines and coagulation factors associated with sub-route with an open date from 1 January 2017 are no longer included in the care activity database. The DBC sub-route together with the associated care activities forms the basis for the declaration of a DBC care product. The sub-route file lists the specific healthcare product concerned (variable MSZZorg product). Finally, there are 'other care products ' (OZP 's) which can be declared separately from the DBC system. These include, for example, operations carried out at the request of the first line or specialisms that do not register DBC 's. The OZP file therefore contains operations within medical specialist care that are outside the DBC system and therefore cannot be linked to a DBC sub-route. Detailed information about the DBC system can be found on the NZa website (https://puc.overheid.nl/nza/doc/PUC_259884_22/1/). From 2016, a new set of DSC files will be created in which the data are based on the claims reimbursed by the health insurers, collected by Vektis. This data is in two files: MSZPrestatieJJJTABVV and MSZZorg ActivitiesJYJJTABVV. 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 files show only the records of patients that could be linked by CBS to the Basic Records Persons (BRP). For the published years, about 99 % (or more) of patients could be linked. This link is based on pseudonyms based on Citizen Service Number (BSN) or the combination of date of birth, gender and zip code. As a Person ID, the variable RINPERSOON is added to the files, a meaningless and dimensionless number, which can be used to link to other CBS SSB files. The files are not complete. The sub-routes in the care type 11 or 21 sub-route file and a declaration code for insured care are 95.3 % complete for 2014 (V3), 92.8 % for 2015 (V2), 85.1 % for 2016 (V1 and V2), 92 % for 2016 (R3), 81.3 % for 2017 (V1 and V2) and 95 % for 2017 (v3). In the sub-route file, an increase weight is given with which the sub- trajectories (linked to the BRP) can be increased to all sub- trajectories closed during the reference year as declared to the health insurers. The most recent files (2016v3 and 2017v3) do not contain increased weight (and are no longer added). Furthermore, a variable has been added to the sub-route file indicating the type of setting and a variable indicating the type of setting of the DBC (clinical, day treatment or outpatient). ### Population Closed DBC sub-programmes in the reference year.本文件属于一组与医学专科诊疗相关的文件集，对应诊断治疗组合（Diagnosis Treatment Combination, DBC）系统及其他可申报诊疗项目中的登记记录。DBC是为患者诊疗全流程提供诊断与治疗信息的诊疗包，此类项目多纳入基本医疗保险报销范围。 诊疗服务开展场所包括医院、独立治疗中心（ZBC）、针对特定疾病的专科机构，以及康复、透析、听力学与放射治疗中心。本数据集基于各机构向荷兰医疗监管局（NZa）管理的DBC信息系统（DBC Information System, DIS）提交的数据生成，对应2012年启用的新版DBC系统。自2013年1月1日起，老年康复专科诊疗被纳入DBC系统。 本次数据集包含3类不同文件：其一为DBC亚路径文件（MSZSub trajectoriesJJJTABVV），其二为对应亚路径的已提供诊疗服务概况文件（MSZSuppliedZorgprofileJJJTABVV），其三为其他诊疗项目文件（MSZOverigeZorgproductenJJJTABVV）。除上述内容文件外，还附带权重文件（MSZUpweightsJJJ），用于将日历年度内处于开放、进行中与已关闭状态的DBC亚路径数量，按照Vektis提供的更完整申报文件调整至边际总量。针对已关闭DBC亚路径的加权系数，已包含在MSZSub trajectoriesJJJTABVV文件中。 当患者向专科医师提出诊疗需求时，DBC登记将为该特定诊疗问题开启一个诊疗流程。一个诊疗流程可包含一个或多个串行DBC亚流程。DBC亚路径（简称DBC）是为申报目的定义的诊疗路径分支，包含时长、诊疗类型、典型诊断与申报数据等信息。2015年起，DBC的最长时长限定为120天；2015年之前则为365天。 本数据集的基础为亚路径文件，其中包含参考年度内所有带有关闭日期的DBC记录。关联的诊疗服务概况文件，收录了参考年度内带有关闭日期的亚路径对应的诊疗路径与诊疗活动信息。亚路径内开展的诊疗活动涉及诊断、治疗、会诊、护理天数及/或高价药品。2017年起，高价药品的申报规则发生调整：2017年1月1日及之后开放的亚路径所关联的高价药品与凝血因子附加费用，不再纳入诊疗活动数据库。DBC亚路径与其关联的诊疗活动共同构成DBC诊疗项目的申报基础。亚路径文件中列明了所涉及的具体医疗服务产品（变量MSZZorg product）。 此外，存在可脱离DBC系统单独申报的其他诊疗项目（Other Care Products, OZP），例如由一线医疗机构发起的手术，或未进行DBC登记的专科服务。因此OZP文件收录了医学专科诊疗中不属于DBC系统、无法关联至DBC亚路径的手术记录。 关于DBC系统的详细信息，可访问荷兰医疗监管局（NZa）官网：https://puc.overheid.nl/nza/doc/PUC_259884_22/1/。 自2016年起，新增一类基于健康保险公司报销申报数据的DSC文件集，此类数据由Vektis收集整理，包含2个文件：MSZPrestatieJJJTABVV与MSZZorg ActivitiesJYJJTABVV。 关于数据获取的更多信息，请访问： > https://www.cbs.nl/nl-nl/onze-diensten/maatwerk-en-microdata/microdata-zelf-onderzoek-doen ### 研究方法 本数据集仅收录荷兰统计局（CBS）可与个人基本记录档案（Basic Records Persons, BRP）进行关联的患者记录。在已公开的年度数据中，约99%及以上的患者可完成关联。关联依据基于公民服务编号（Citizen Service Number, BSN）生成的假名，或出生日期、性别与邮政编码的组合信息。文件中新增了RINPERSOON变量作为个人标识，该变量为无意义的无量纲数值，可用于关联荷兰统计局其他社会统计文件。 本数据集并非完整数据集：2014年（V3版本）的11类或21类亚路径文件中，符合参保诊疗申报代码的记录完整度为95.3%；2015年（V2版本）为92.8%；2016年（V1与V2版本）为85.1%，2016年（R3版本）为92%；2017年（V1与V2版本）为81.3%，2017年（v3版本）为95%。在亚路径文件中，已提供加权系数，用于将关联至BRP的亚路径数量调整至参考年度内向健康保险公司申报的所有已关闭亚路径总量。最新的2016v3与2017v3版本文件不再包含加权系数（亦不再进行加权调整）。 此外，亚路径文件中新增了两类变量：一类用于标识服务场景类型，另一类用于标识DBC的服务场景类型（临床诊疗、日间治疗或门诊诊疗）。 ### 研究对象 参考年度内已关闭的DBC亚诊疗项目。