Illness episodes of clients of general practice participating in Nivel Care Registrations Eerste Lijn (from 01-01-2018)

This file contains all disease episodes of people registered with general practitioners who participate in Nivel Care Registrations Eerste Lijn (NZR). A disease episode consists of one or more contacts with the general practitioner for the same complaint or illness and indicates during which period during the reporting year the complaint or illness was present. The complaint or disease in question is marked with a diagnostic code, coded according to the International Classification of Primary Care-1 (ICPC-1). Each record involves one disease episode, individuals may have multiple disease episodes in one year and thus occur several times in this stock. These files can only be used within the CBS after the permission of Nivel, the use is associated with costs. External researchers can submit a data request via the Nivel website. After approval, Nivel will in most cases (for a fee) create a specific custom file that is focused on the research question. 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 data from this file is used in combination with the data from the NZRClient file, which contains the data on all enrolled patients with the NZR general practitioners. A disease episode (further called &episode ') is the period between the time a patient first comes to the GP with a complaint and the moment the disease is healed or the patient has died. In chronic diseases, an episode is not closed, but people continue to count for that diagnosis over the years until the patient dies. Episodes of diseases or conditions of which the patient can heal are automatically closed if there has been no contact with the GP for a specified period of time. This shutdown period varies by type of condition and varies between 4 weeks and 1 year after the last contact. The end date of the disease episode is then established on the date of last contact plus half of the cut-off period. There is no direct relationship between the number of episodes and the number of GP contacts of a person. An episode may consist of one or more contacts with the GP over a longer period of time, while during a contact with the GP several topics may be discussed that belong to different episodes. This file contains the episodes that were present in (part of) the reporting year with clients present in NZRClient. This stock also includes a high weight, with which the results of the episodes can be increased to the entire Dutch population. For each disease episode, the start and (estimated) end date are displayed. Because chronic diseases do not close the episode, disease episodes of chronic diseases do not have an end date. If a client was enrolled in a practice that supplies useful disease episodes, but there are no illness episodes of the client in this file, the client has not had any disease episodes in the year under review. As of fiscal year 2018, Nivel no longer supplied raw source files to CBS, but reprocessed files that Nivel used for its own analyses. These reworked files contain largely the same variables as the raw files, but some registration errors have already been removed from them, such as duplicate records based on the Nivel patient number. As of fiscal year 2018, six variables have no longer been included in the episode file provided by Nivel. These include additional data per disease episode, namely the dates of the first and last contact and the number of contacts with the general practitioner in the context of this disease episode, and the dates of the first and last prescriptions and the number of prescriptions of medicines for this disease or condition. These variables are still present in NZREpisode, but are no longer filled. The 2018 client base includes relatively fewer clients than the files of previous years (approximately 10 % less), because the NZR practices connected to one particular General Practitioner Information System (HIS) had not yet provided data at the time of Nivel’s production of the analysis files. As a result, fewer disease episodes were included in NZREpisode in reporting year 2018. ### Population Disease episodes constructed by Nivel from persons enrolled in general practice participating in Nivel Zorgregistrs Eerste Lijn (NZR).本数据集收录了参与Nivel基层医疗注册（Nivel Care Registrations Eerste Lijn，NZR）的全科医生签约人群的全部疾病病程。疾病病程指针对同一主诉或病症的一次或多次全科诊疗接触，并标明该主诉或病症在报告年度内的持续时段。所涉主诉或病症将按照《国际基层医疗分类第1版》（International Classification of Primary Care-1，ICPC-1）编码，并赋予诊断代码。每条记录对应单一段疾病病程，一名个体在单一年度内可拥有多段病程，因此在本数据集中可多次出现。 本数据集仅可在获得Nivel许可后于荷兰中央统计局（Central Bureau of Statistics，CBS）内部使用，且使用需承担相关费用。外部研究人员可通过Nivel官网提交数据申请，获批后Nivel通常会（收取费用）针对研究需求定制专属数据集。 数据获取详情请参见： > https://www.cbs.nl/nl-nl/onze-diensten/maatwerk-en-microdata/microdata-zelf-onderzoek-doen ### 研究方法 本数据集需与NZRClient数据集结合使用，后者收录了与参与NZR的全科医生签约的全部患者信息。 疾病病程（下文简称「病程」）指患者首次因主诉就诊至病症痊愈或患者死亡之间的时段。对于慢性病，病程不会终止，患者将持续被计入该诊断范畴直至其死亡。对于可自愈的疾病或病症，若患者在特定期限内未再前往全科医生处就诊，则病程将自动终止。该终止时限因病症类型而异，范围为末次接触后4周至1年不等。此时疾病病程的结束日期将设定为末次接触日期加上终止时限的一半时长。 个体的病程数量与全科诊疗接触次数并无直接关联。一段病程可在较长时段内包含一次或多次全科诊疗接触，而单次诊疗中可讨论多个分属不同病程的健康议题。本数据集收录了在报告年度（或部分时段）内存在且在NZRClient数据集中有记录的患者病程。本数据集还包含统计权重变量，可通过该变量将病程相关研究结果外推至全荷兰人群。 每段疾病病程均会记录起始日期与（估算的）结束日期。由于慢性病病程不会终止，因此慢性病的病程无结束日期。 若某签约患者所属的诊疗机构可提供有效病程数据，但本数据集中无该患者的病症记录，则说明该患者在报告年度内无相关疾病病程。 自2018财年起，Nivel不再向CBS提供原始源数据集，而是提供自身分析所用的再处理数据集。此类再处理数据集与原始数据集的变量大体一致，但已剔除部分登记错误，例如基于Nivel患者编号识别的重复记录。 自2018财年起，Nivel提供的病程数据集不再包含6项变量。此类缺失变量包括每段病程的相关附加数据：首次与末次诊疗接触日期、该病程对应的全科诊疗接触次数，以及针对该病症的首次与末次处方日期、处方药物总数量。此类变量仍存在于NZREpisode数据集中，但已不再填充数值。 2018财年的签约患者样本量较往年有所减少（降幅约10%），原因是某特定全科医生信息系统（General Practitioner Information System，HIS）对接的NZR签约机构在Nivel生成分析数据集时尚未提交数据。因此2018报告年度的NZREpisode数据集收录的病程数量有所减少。 ### 研究人群 本数据集的疾病病程由Nivel基于参与Nivel Zorgregistrs Eerste Lijn（NZR）的全科医生签约人群构建。