3. New sources and improved utilisation of existing sources
The revision described in this publication has been made possible by the availability of new data sources and improved utilisation of existing sources. A summary of the most important sources and their impact is given below:
1. Linking Zvw and Wlz claims to the business register
At the request of CBS, Vektis has aggregated the claims available to them (at the individual and provider level) to amounts per delivery code (‘prestatiecode’) and per provider. By making use of the Vektis AGB register, these amounts have been linked to the CBS business register. This makes it possible to determine the total amount of each care type claimed per group of healthcare providers, classified in accordance with the SBI. It also allows a calculation of the volume of insured care provided by companies that provide care as a secondary activity (outside the Human Health and Social Work Activities section). The care type is determined by grouping delivery codes (for both Zvw and Wlz), and by also making use of indications (data on care needs) from the Care Needs Assessment Centre (CIZ) for Wlz care.
2. Linking CAK figures on personal contributions to the healthcare providers that supplied the care
The Central Administration Office (CAK) data provide a detailed insight into the personal contributions that individuals pay for both Wlz care and Wmo residential care. For Wlz care, these contributions are linked to the care delivered per person and then assigned to the care provider that submits a claim for that care. For Wmo residential care, CBS does not have data for care claims, but it does have figures for total personal contributions per person and AGB code. By linking the AGB register to the business register, this personal contribution for Wmo residential care can be assigned to healthcare providers. These detailed data create a more accurate picture of the financing flows.
3. Linking information from different sources on personal budgets (cash benefits)
It was already possible to link personal budgets to healthcare providers with the information on personal budgets held by the Social Insurance Bank (SVB). That existing linkage has been improved. By combining that data with the indications from the CIZ, it is now also possible to break down the personal budgets by care type up to a certain point.
4. More intensive use of fiscal data and public annual reports
Since the 2021 reporting year, prompted by the European requirement relating to Structural Business Statistics (SBS), CBS has begun compiling economic statistics for virtually the entire Human Health and Social Work Activities section (SBI divisions 86, 87, 88). Previously, there were no comprehensive data available on revenues and costs for all components within the Human Health and Social Work Activities section. In order to produce economic statistics for those components, CBS is now making intensive use of fiscal data, supplemented by information from public annual reports (especially for foundations). This has meant that data have become available for components of the Human Health and Social Work Activities which were lacking before the revision, in particular: a large part of the ‘Other paramedical practitioners’ subclass (86919), part of the ‘Practices of psychologists’ subclass (86913), part of the ‘Preventative health care’ subclass (86923), the ‘Umbrella organisations in the field of health care and other support activities for health care’ subclass (86929), the ‘Counselling and welfare for disabled’ subclass (88103) and the ‘Community centres, other consultancy and cooperative bodies in the field of social care’ subclass (88999).
5. Use of open data from the national government
Following the revision, CBS is making use of open databases of the national government, which contain data on subsidies, contributions to other public authorities, income deductions and financing to agencies. Because many of these files contain the Chamber of Commerce registration numbers of the recipients, it is possible to link these amounts to the CBS business register and so allocate them to the correct provider category. This information is then used to improve the breakdown of care expenditure by financing source.
6. Wider use of DigiMV annual reports
Annual reports filed by care institutions that fall under the Care Institutions (Accreditation) Act (WTZi), the Child and Youth Act (‘Jeugdwet’) and, since 2022, under the Care Providers (Accreditation) Act (WTZa) were already used before the revision. Before the revision, the focus was on units from the CBS Care Institutions statistics, i.e.: University Medical Centres (UMCs), general hospitals, specialist hospitals, residential mental health care, care for the disabled, residential youth care, shelter care, ambulatory youth care, and residential nursing care and home care. After the revision, these data sources have also been used for healthcare providers outside those sections as far as possible, primarily in order to obtain more information about financing flows under the Wmo and Child and Youth Act. This is because the supplementary CBS survey which is part of the DigiMV reporting requirement contains the revenues per Act of Parliament (Zvw, Wlz, Wmo and Child and Youth Act).
7. Identification of subcontractors by means of extensive source linking
Linking various sources to the CBS business register, such as Zvw and Wlz claims, personal budgets (cash benefits), the BIG register (healthcare professions), the SKP register (Quality Register of Paramedics), the AGB register and the population of Respondents for Youth Policy Information (‘Berichtgevers voor Beleidsinformatie Jeugd’), has produced improved insight into which companies (potentially) function as subcontractors. This extensive utilisation of sources helps to more accurately catalogue the complexity of the care chain and improves the extent to which corrections can be made for (potential) double counting in the Health and Social Care Accounts.
The most important elements of the revision are explained in more detail below:
- the new classification of Health and Social Care providers
- the new breakdown by care type
- the approach to preventing double counting
After this, the other changes resulting from the revision are described and the figures for 2021, 2022 and 2023 are presented.