National Health Insurance Fund Outpatient Consultation Data, Bulgaria

This dataset contains physician-level, diagnosis-specific monthly counts of outpatient consultations reimbursed by the Bulgarian National Health Insurance Fund (NHIF/НЗОК). Data are disaggregated by Regional Health Insurance Fund (RHIF/РЗОК), individual physician identifier, medical specialty, ICD-10 diagnosis code, care setting (general practice vs. specialist outpatient), and type of visit (primary vs. secondary ambulatory consultation and referrals). The dataset covers 25 monthly reporting periods from January 2024 through January 2026. Data Source The original data were published as monthly Excel files by the NHIF (Национална здравноосигурителна каса) through its open data portal. Each monthly file contained two worksheets: one for general practitioners (primary care physicians, specialty code 00) and one for medical specialists in outpatient settings. The files were combined into a single CSV using R, with variable names translated to English and a care setting indicator (gp / specialist) added. Variables Variable Type Description rhif_code character Two-digit code identifying the Regional Health Insurance Fund (РЗОК), zero-padded (01–28) rhif_name character Name of the RHIF in Bulgarian (e.g., "РЗОК Благоевград") rhi_physician_id character Unique physician identifier assigned by the Regional Health Inspectorate (РЗИ) specialty_code character Two-digit medical specialty code per NHIF classification; 00 denotes general practice icd10_code character ICD-10 diagnosis code (e.g., E11.9, J06.9) icd10_name character ICD-10 diagnosis name in Bulgarian n_referrals integer Number of referral documents issued (Бр. ИМП — направления) n_primary_visits integer Number of primary (first) ambulatory consultations for the given diagnosis n_secondary_visits integer Number of secondary (follow-up) ambulatory consultations for the given diagnosis activity_month character Reporting month in MM.YYYY format as recorded in the source files activity_date date First day of the reporting month, derived from activity_month (YYYY-MM-DD) setting character Care setting: gp (general practice / primary care) or specialist (outpatient specialist) source_file character Name of the original xlsx file from which the record was extracted Temporal Coverage January 2024 – January 2026 (25 months) (Updated regulary) Spatial Coverage All 28 Regional Health Insurance Fund districts in Bulgaria. Record Count Approximately 13,886,591 rows in the combined dataset. Methodology The 25 source xlsx files were read using the readxl R package. Both worksheets from each file were extracted, tagged with the care setting label, and concatenated. Column names containing Bulgarian text and irregular whitespace were normalised using stringr::str_squish() and mapped to English equivalents. Numeric count variables were cast to integer. The activity_date variable was parsed from the original MM.YYYY string using lubridate::dmy(). No records were filtered, deduplicated, or otherwise modified; the dataset represents the complete contents of the source files as published by the NHIF. Known Limitations The dataset reflects administrative claims data and counts reimbursed consultations, not unique patients. A single patient may appear in multiple rows across physicians, diagnoses, and months. Specialty code 00 denotes general practice; the full NHIF specialty code classification should be consulted for interpretation of other codes. ICD-10 diagnosis names are in Bulgarian as provided by the NHIF source files. Five months from 2024 are absent in the source data (March, May, June, August, and — verify against your files — others), reflecting availability on the NHIF open data portal at the time of download. [Adjust this note to match the actual file list if all 25 months are present.] License This dataset is derived from publicly available administrative data published by the Bulgarian NHIF. Please verify reuse conditions with the original data provider. The processing code is provided under the MIT License. Contact Kostadin Kostadinov Department of Social Medicine and Public Health Medical University of Plovdiv Plovdiv, Bulgaria