HISLink - Linkage of Health Interview Survey Data with Health Insurance Data

Last updated on 11-4-2024 by Cassandre Dugailliez
Project duration:
January 1, 2017
Project with no end date

In short

The Health Interview Survey (HIS) and the data collected in the framework of the Mandatory Health Insurance, which are hosted by the Intermutualist Agency (IMA) are complementary data sources within the Belgian health information system. Self-reported information is collected during the HIS on the health status, life style, health care use and socio-demographic background characteristics of a representative sample of the population in Belgium. The IMA database is an administrative database with detailed information on reimbursed health care expenses of the total population. Through an individual linkage of HIS and IMA data, it is possible to address health policy relevant questions that each of the data sources separately cannot answer.


Project description

In Belgium more than 99% of the population participates in the mandatory health insurance. As a result IMA data include detailed and extensive information on reimbursed health expenses for nearly the whole population. This information is extensively used by health decision makers, especially the National Institute for Health and Disability Insurance (NIDHI), to plan and monitor policy measures.

However, health insurance data have some shortcomings:

  1. they provide essentially information on the use of health care and health care expenditures, but information on non-reimbursed health care use is lacking
  2. there is no link between health care use and health needs
  3. information on socio-demographic background characteristics is scarce.

This project tries to overcome these shortcomings by linking IMA data with HIS data, which cover the following topics: socio-demographic characteristics, health status, lifestyle and health care use. Most of these topics are not or only marginally covered by the IMA database. A first linkage was performed with the HIS2008 . The current HISlink project consists of recurrent linkages between each new HIS data wave and IMA data. Up to know new linkages have been performed with data from the HIS2013 and the HIS2018.  The linkage procedure with data from the HIS2023 is under preparation. The project is specifically meant to respond to policy relevant questions raised by NIDHI (who is the commissioner of this project). Domains covered are, among others, socio-demographic differences in use of health care, evaluation of chronic morbidity indicators used by NIDHI and use of non-reimbursed medicines. More specifically, the linked data are used:

  • to study access to health care
  • to explore specific questions with respect to the use of medicines (including non-reimbursed medicines)
  • for data evaluation, validation
  • to study of the determinants of health care utilisation
  • to construct new IMA-based indicators in the framework of HIS reports
  • for population health monitoring, health surveillance and planning
  • for health care research and quality of care assessment
  • for  other specific NIHDI research questions
  • for studies assessing the economic impact of diseases and ill health

During the first year of a new linkage the focus lies on the planning and the implementation of the data linkage. A linkage scheme is developed in collaboration with the partners (Statbel, IMA). Variables that will have to be included from both databases are identified and an authorization request is submitted to the Information security committee. Once the data are available analyses, activities and studies are conducted in line with the objectives stated above. Results are presented in yearly reports to the commissioners and scientific papers.



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