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Chapter 484MethodStudy design and data sourceThis population-based database study investigated the prevalence of a range of MH disorders and care provided to all patients utilising advanced MH services in the Netherlands between 1 January 2015 and 31 December 2017. Information was retrieved from health insurance claims, which are collected in a central database at Statistics Netherlands (SN), the Dutch national statistics office. 11 In the Netherlands, MH services are subdivided into basic MH services, for mild and low-complex MH problems, and advanced MH services, for more severe and complex MH disorders. 12Both types of MH services are accessible to all patients after assignment and referral by a general practitioner, and all costs involved are covered by mandatory health insurance. Health insurance claims submitted by MH care providers are collected and processed in a standardised manner and available at SN for research purposes in the SN-MH service database. This study focused on patients with more severe and complex MH disorders in advanced MH services, which for the sake of readability are called MH services in the rest of this article. In the MH service files, an ID can be reported as a contributing diagnosis. To take potential under-recognition and underreporting of MID in MH services into account, 7 the MH service database was linked to a combined social services and long-term care database that included all users (in 2015) of services under the Chronic Care Act, the Disability Benefit Act, or the Sheltered Employment Act and for whom MID was indicated as the reason for calling upon any of these services. This is the largest available national dataset on Dutch individuals with MID based on SN research commissioned by the Ministry of Health. 13 This linkage allowed the generation of two MID subgroups: one with and one without an ID registration in the original MH service database (Figure 1). The comparison group (no ID) consisted of all other MH patients without an (M)ID registration in any of the databases used. We included persons aged 18 years or older in 2015 who were available for at least one year follow-up and completed their trajectory before 31 December 2017. Patients aged 75 years and older were excluded Katrien Pouls sHL.indd 84 24-06-2024 16:26