Belgium
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Healthcare System
Belgium's healthcare system is a compulsory, social health insurance system. It operates under a model that combines both public and private sectors, with a blend of universal coverage and income-based premiums.
The system is managed by the Ministry of Health at the national level, composed of the Federal Public Service for Health, Food Chain Safety, and Environment, and by regional governments in Flanders, Wallonia, and Brussels-Capital. Health insurance funds, known as "mutualities," are responsible for the management of the social health insurance system.
The Belgian population receives a wide range of healthcare benefits through the system, including primary care, specialist care, hospital care, mental health services, dental care, maternity care, rehabilitation services, and prescription medications. Preventive care and health promotion services are also provided. There is no gatekeeping system in place.
All Belgian residents are required to join a health insurance fund, which is typically linked to their employment or their family's employment. Access to healthcare benefits is granted upon registration with a health insurance fund, and coverage extends to dependents as well. The system is funded by income-based contributions from employees, employers, and the government, ensuring comprehensive coverage for all citizens.
Belgium has implemented a nationwide electronic health record (EHR) system called eHealth. This platform securely centralizes patients' medical records, allowing healthcare providers to access and update relevant information. Data from insurance claims, registries, and other sources is also collected and stored in the eHealth system, which aims to improve the overall efficiency and quality of care while maintaining patient privacy.
Administrative or Claims Data
Database: AIM-IMA Healthcare Data
Sponsor, manager or home institution: AIM-IMA.
Primary purpose: To store information on reimbursed health care services provided to members of Belgium's seven health insurance funds under compulsory health insurance.
Type of information: Data Dictionary: AIM-IMA Healthcare Data. More information about the database [1].
Source of Information: Health insurance fund records.
Data level: Patient level.
Number of Records: 99% of the population of Belgium.
Date Range: October 2005 onwards.
Cancer Areas of Interest: Unknown.
Open data access: Partially publicly available [2]. Instructions to request data for restricted content [3].
Information/Contact for data request: Contact information [4].
Database: AIM-IMA Pharmanet
Sponsor, manager or home institution: AIM-IMA.
Primary purpose: To store information on reimbursed drugs and medical devices dispensed in Belgian public pharmacies for members of the seven health insurance funds.
Type of information: Data Dictionary: AIM-IMA Pharmanet. More information about the database [5].
Source of Information: Health insurance fund records.
Data level: Patient level.
Number of Records: 99% of the population of Belgium.
Date Range: 2004 onwards.
Cancer Areas of Interest: Unknown.
Open data access: Partially publicly available [6]. Instructions to request data for restricted content [7].
Information/Contact for data request: Contact information [8].
Database: AIM-IMA Échantillon Permantent(e) Steekproef (EPS)
Sponsor, manager or home institution: AIM-IMA.
Primary purpose: To provide a longitudinal compilation of administrative health insurance data for federal and regional partners in Belgium.
Type of information: In the EPS database are all the variables available in the Population, Healthcare, Pharmanet and Hospitalizations databases [9].
Source of Information: Health insurance fund records.
Data level: Patient level.
Number of Records: 2.5% of the Belgian population (2019: approximately 285,000) and an additional sample of 2.5% of the Belgian population aged 65 and over (2019: approximately 56,000).
Date Range: 2002 onwards.
Cancer Areas of Interest: Unknown.
Open data access: Partially publicly available [10]. Instructions to request data for restricted content [11].
Information/Contact for data request: Contact information [12].
Registries
Database: Belgian Cancer Registry
Sponsor, manager or home institution: Belgian Cancer Registry.
Primary purpose: To collect and provide information about cancer in the country
Type of information: Data dictionary was not found.
Available type of information: Cancer incidence, sex, age-specific, age group, year, tumour type and region [13].
Source of Information: Healthcare facilities that have oncology care programs and provide services for pathological anatomy are required by law to collaborate with cancer registration.
Data level: Patient level.
Available data level: National and regional level.
Number of Records: Unknown.
Date Range: 1997 onwards.
Cancer Areas of Interest: Head and neck (C00-C14, C30-C32); Oesophagus (C15); Stomach (C16); Colon and rectum (C18-C20); Liver, galbladder and bile ducts (C22-C24); Pancreas (C25); Lung (C34); Bone (C40-C41); Malignant melanoma (C43); Breast (C50); Cervix uteri (C53); Corpus uteri (C54); Ovary (C56); Prostate (C61); Testis (C62); Kidney (C64); Bladder (C67); Meninges, brain and central nervous system (C70-C72); Thyroid (C73); Hodgkin lymphoma (C81); Non-Hodgkin lymphoma (C82-C86); Myeloma (C90); Leukaemia (C91-C95); Myelodysplastic syndromes – Myeloproliferative disorders (MDS-MPD); Invasive tumours (excl. non-melanoma) (C00-C43, C45-C97).
Open data access: Partially publicly available [14]. Instructions to request data for restricted content [15].
Information/Contact for data request: Contact information [16].
Database: StatBel Cause of Death Registry
Sponsor, manager or home institution: Statistics Belgium.
Primary purpose: To compile statistics on causes of death in Belgium using statistical declaration-of-death forms and WHO's ICD-10 coding.
Type of information: Cause of death and number of deaths, month, year, age group, sex, and region [17]. Further sociodemographic and medical information is available on request, both for citizens in aggregated form and for scientific research in the form of microdata.
Source of Information: Statistical declaration-of-death forms (Model IIIC and Model IIID) that are filled out by a certifying physician and completed by the municipal administration of the place of death for every death that occurs in Belgium, which are then forwarded to the Communities and aggregated by AD Statistics to compile the statistics at the federal level. In addition to the death registration forms, the data are supplemented by information on deaths registered in the RNPP (National Population Register). See documentation [18].
Data level: Patient level.
Available data level: National and regional level.
Number of Records: Unknown.
Date Range: 1998 onwards.
Cancer Areas of Interest: Neoplasms (C00-D48).
Open data access: Partially publicly available [19]. Instructions to request data for restricted content [20].
Information/Contact for data request: Contact information [21].
Databases for Clinical Trials, Surveys and Biobanks
Biobank: The Belgian Virtual Tumourbank
Primary purpose: Store the sample collection and data information of participants from
Sponsor, manager or home institution:
Type of information:
Data level: Respondent level.
Number of Records: About
Date Range: .
Cancer Areas of Interest: Unknown.
Open data access: Partially publicly available []. Instructions to request data for restricted content [].
Information/Contact for data request: Contact information [].
Electronic Health Records
Health Portal: MaSanté
Sponsor, manager, or home institution: Federal Public Service.
Primary Purpose: Provides access to personal health data and general health information, such as current health status, reports and results, medicines, vaccinations and many other personal information.
Number of records: Unknown.
Data source: Data inserted by healthcare providers.
Date range: Unknown.
Contact Information: Information [22].
Clinical Practices Guidelines
KCE Guidelines
Sponsor, manager or home institution: Federaal Kenniscentrum voor de Gezondheidszorg.
Primary purpose: Provides evidence-based recommendations for management, diagnosing, treating, and following up of many types of cancer.
Type of information: Guidelines information about management and quality of life of cancer patients, diagnoses, treatment and follow up of many types of cancers, such as breast cancer, renal cancer, ovarian cancer, bladder cancer, etc.
Access to information: List of guidelines [23].
Compilation: ESMO Patient Guides
Sponsor, manager or home institution: European Society for Medical Oncology
Primary purpose: To translate complex medical language into understandable information for patients.
Available guides: Side Effects of Immunotherapy and Its Management; AML; Bone Sarcomas; Colorectal Cancer; Endometrial Cancer; Follicular Lymphoma; Glioma; Head and Neck Cancers; CML; Stomach Cancer; Soft Tissue Sarcomas.
Type of information: Information on each guide varies for each cancer type. Generally, guides provide definitions, explanations of causes, diagnosis, treatment, treatment options, care after treatment, among others.
Access to information: List of guides [24].
Latest Policymaking Initiatives
Report: Belgian Cancer Barometer
Sponsor, manager or home institution: Stichting Tegen Kanker.
Primary purpose: To create a comprehensive reference work on cancer care in Belgium, providing a global overview and determining priorities for fighting cancer on all fronts, with the collaboration of various organizations and experts in the field.
Type of information: Number of new cancer diagnoses; Cancer incidence; Most frequent cancers; Cancer mortality, survival and prevalence; People invited, total coverage and response rate according to population survey and region of cancer screenings; Diagnoses, treatment and palliative care general information.
Data level: National and regional level.
Access to information: Access Information [25].
Report: EU Country Cancer Profile 2023
Sponsor, manager or home institution: OECD and European Commission.
Primary purpose: To provide reliable data on cancer prevention and care, identifying trends, disparities, and inequalities among EU Member States and regions to guide interventions under Europe's Beating Cancer Plan.
Type of information: National cancer burden; Cancer incidence and mortality; Risk factors for cancer; Early detection programs (screenings); Cancer care performance, The impact of COVID-19 on cancer care.
Data level: National level.
Access to information: Access Information [26].
Reports: KCE Organisation and financing of health care
Sponsor, manager or home institution: Federaal Kenniscentrum voor de Gezondheidszorg.
Primary purpose: Provides reports about the performance of the Belgian health system.
Type of information: Reports information about the performance of the Belgian health system; Palliative care; Survival and quality of care in Belgian hospitals; Integrated care, etc.
Access to information: List of reports [27].
