The complexity of healthcare that citizens receive makes it necessary to set up appropriate information systems that accurately and timely meet the demand for information for the right development of the health services planning and assessment functions.

In Royal Decree 1360/1976 of 21 May, for which the use of a registration book by health establishments with a boarding system is made compulsory, compulsory creation by all the centers of a book of record of income and high hospital. In the Resolution of the Directorate-General for Health on the book of registration of patients with health facilities with a boarding school, it was stated that the reason was " to expand the knowledge of the hospital sector and to serve for the statistical knowledge of hospital morbidity " and should be collected, among others the number of medical history, date of birth and sex, dates of admission and discharge, the request and type of income as well as the diagnosis of income and to the high and the high type.

In 1981, within the Commission of the European Communities, under the auspices of the European Bureau of the World Health Organization, the Hospital Committee of the European Economic Community and the European Association of Medical informatics, the Basic Minimum Set of Data to the hospital discharge was defined as a core of minimal and common information on the episodes of hospitalization, proposing to the Member States its creation as a basis for the management, the planning and evaluation of health care and services as well as for research epidemiological and clinical. Coverage should include both hospital and outpatient care.

Law 14/1986, of 25 April, General of Health, states in its article 23 that " the health administrations, in accordance with their competences, will create the records and develop the analysis of information necessary for the knowledge of the different situations from which actions can be derived from the health authority ".

In 1987, the Interterritorial Council of the National Health System (CISNS) decided to adapt to international recommendations regarding the collection of care information. In this way, it approves the Minimum Basic Data Set (CMBD), which includes a set of administrative and clinical data in a standardized manner for each health care contact that allows to know the morbidity attended in the public hospitals and private.

For their part, the autonomous communities, in the exercise of their competencies in the field of health care management, have since been publishing norms for the implementation of different models of CMBD for their respective centres and services.

Law 16/2003, of 28 May, of cohesion and quality of the National Health System, provides, in Article 53, that the Ministry of Health, Social Services and Equality will establish a system of health information of the System National Health (SNS) to ensure the availability of reciprocal information and communication between health administrations. To this end, the objectives and content of the information will be agreed within the CISNS. In addition, Article 55 states that " the health information system shall specifically provide for the production of statistics for State purposes in the field of health, as well as those of general interest and those which are result from commitments to supranational and international organisations, which will be carried out in accordance with the methodological and technical determinations established by the Ministry of Health and Consumer Affairs, consulted by the CISNS. The information needed for the compilation of statistics on health activities will be collected from both the public and private sectors. "

Regulation (EC) No 1338/2008 of the European Parliament and of the Council of 16 December 2008 on Community statistics on public health and health and safety at work is hereby approved in the European Union in 2008. which lays the foundations for the establishment of a public health information system that provides an overview of the state of health and its determinants as well as the health systems of the Member States.

The Royal Decree 1658/2012 of 7 December, approving the National Statistical Plan 2013-2016 (PEN), is the normative framework that encompasses all the statistical operations produced for state purposes guaranteeing the supply to the State, the European Union, the institutions and the users of the necessary statistical information. The PEN includes the statistical exploitation of the CMBD among the statistical operations of the health sector.

Over all these years, the state CMBD has been incorporating new variables; thus, in 1998 the type of financing was included and in 2005 the CIP (personal identification code) of the health cards was included. individual and the identification of the clinical service responsible for the discharge of the patient.

Also, since the end of the 1990s, the outpatient activity has been integrated into the database of the CMBD, mainly related to surgical procedures performed on an outpatient basis. Subsequently, and after successive trials of the application of the corresponding data models, data from other outpatient care modalities such as the hospital of medical day and the hospitalization have been added. The result of these experiences has served as a model for articulating, on the basis of the state CMBD, the current proposal for the structure of the Register of specialized health care activity.

In the processing of this royal decree have been consulted the Autonomous Communities and the Cities of Ceuta and Melilla, has submitted to the plenum of the CISNS and also has a mandatory report of the Spanish Agency of Protection Data.

This royal decree has the character of basic legislation and is dictated under the jurisdiction of article 149.1.16. the Spanish Constitution is attributed to the State in the field of bases and general coordination of health.

In its virtue, on the proposal of the Minister of Health, Social Services and Equality, in agreement with the Council of State and after deliberation of the Council of Ministers at its meeting of 6 February 2015,

DISPONGO:

CHAPTER I

General provisions

Article 1. Object.

This royal decree is intended to regulate the Register of Specialized Health Care Activity, which is henceforth registered, based on the current Minimum Basic Data Set (RAE-CMBD), as well as establishing its structure and content.

Article 2. Nature and purpose.

1. The registry has administrative nature and is integrated into the Health Information System of the National Health System provided for in Article 53 of Law 16/2003, of 28 May, of cohesion and quality of the National Health System.

2. The registry, as part of the Health Information System of the National Health System, aims to ensure the availability of the information corresponding to the specialized health care activity, responding to the information needs of the different actors involved in the health system, as set out in Articles 53 and 55 of Law 16/2003 of 28 May.

These are targets for the registry:

a) To know the care demand and the morbidity attended in the specialized care devices and to favor the conduct of studies of clinical, epidemiological and evaluation of health services and of health outcomes.

b) Provide autonomic records with the information necessary for the evaluation and control of the care provided in the National Health System as a whole.

c) Facilitate the performance of health sector statistics at the state level, as well as those resulting from commitments to international official bodies.

Article 3. Scope of application.

1. This legislation affects both hospitals and outpatient centres providing specialist services, both public and private.

2. The scope of application of the registry covers both hospitalization and the care modalities for hospitalization at home, medical day hospital, outpatient surgery, outpatient procedures of special complexity and emergency.

Article 4. Competent body.

1. The register is attached to the Directorate-General for Public Health, Quality and Innovation of the Ministry of Health, Social Services and Equality, which will be the body responsible for its organization and management and the responsible for adopting the measures that ensure the confidentiality, security and integrity of the data contained in the registry.

2. It corresponds to the Directorate General of Public Health, Quality and Innovation of the Ministry of Health, Social Services and Equality, any decision or agreement concerning the subject matter of the register regulated in this royal decree, according to established in Article 53 of Law 16/2003 of 28 May.

CHAPTER II

Record characteristics

Article 5. Contents of the record.

1. The record will contain the following data:

1. Type of Personal Identification code.

2. Personal Identification Code.

3. Number of medical history.

4. Date of birth.

5. Sex.

6. Country of birth.

7. Postal code of the patient's usual address.

8. Municipality of the patient's usual address.

9. Financing scheme.

10. The start date and time of the care.

11. Date and time of the order of entry.

12. Type of contact.

13. Type of visit.

14. Provenance.

15. Circumstances of attention.

16. Service responsible for care.

17. The end date and time of the care.

18. Type of high.

19. Care continuity device.

20. Date and time of intervention.

21. Entry into Intensive Care Unit.

22. Days of stay in Intensive Care Unit.

23. Primary diagnosis.

24. POA1 marker of the main diagnosis.

25. Secondary diagnostics.

26. POA2 marker for secondary diagnostics.

27. Procedures performed at the center.

28. Procedures performed in other centres.

29. Morphology codes for neoplasms.

30. Health center.

31. Autonomous community of the health center.

2. The autonomous communities in the field of their competences may establish their respective registration models, incorporating, in addition, other data they deem appropriate.

3. No data on ideology, belief, religion, racial origin, or sexual orientation of the patient may be included in the register.

Article 6. Unit of record.

1. The unit of registration is, in general, the contact, defined as the healthcare provided under the same care modality and uninterruptedly by a healthcare provider to a patient.

2. The contact types, depending on the care mode, are:

a) Hospitalization.

b) Home hospitality.

c) Medical day hospital.

d) Outpatient surgery.

e) Outpatient procedure of special complexity.

f) Urgency.

3. The definitions, inclusion and exclusion criteria and the exceptions for each of the contact types are set out in Annex I.

Article 7. Data model and support.

1. The data model is made up of the variables listed in Article 5 and its structure, format and characteristics are defined in the annexes of this royal decree.

2. The register will be implemented in digital support and its design and structure will allow the exchange of data and its exploitation to be carried out by electronic means.

CHAPTER III

Processing the information

Article 8. Incorporation and access to the log data.

1. In accordance with Articles 53 and 55 of Law 16/2003 of 28 May, the autonomous communities and, where appropriate, the health centres, shall be obliged to supply the data to the body responsible for the registration.

2. Each Autonomous Community shall supply the data to which it is required in accordance with the timetable established by the Ministry of Health, Social Services and Equality.

3. According to the provisions of article 53.5 of Law 16/2003, of 28 May, each Autonomous Community will have access to the data in the register corresponding to the care received in other autonomous communities by citizens residing in its field. territorial.

Also, the administrative mutual societies of the special social security systems of officials (MUFACE, MUGEJU and ISFAS), will have access to the data of the register corresponding to their respective protected collective.

Article 9. Security measures in the processing of data.

1. The Ministry of Health, Social Services and Equality shall take the necessary measures to ensure that the processing of the data is carried out in accordance with the purposes set out in Article 2 of this royal decree.

2. It shall also provide appropriate measures to ensure the security of the processes of dispatch, disposal, custody and exploitation of the information, in accordance with the provisions of Royal Decree 1720/2007 of 21 December 2001 approving the Regulation of the development of Organic Law 15/1999, of 13 December, of protection of personal data.

3. Any treatment that leads to the access to or the transfer of the data from the registry shall be carried out in the terms that are agreed upon in the Interterritorial Council of the National Health System (CISNS), as provided for in Article 53 of the Law 16/2003, of 28 May, and with the guarantees provided by the Organic Law 15/1999, of 13 December. This applies to the use of dissociation and encryption techniques, as well as all mechanisms to ensure the confidentiality of the data in the register.

4. Both for the provision and for the consultation of the register data by the Autonomous Communities, it will be necessary to use the recognised electronic certificate systems. To facilitate access for authorized users, different profiles will be established for each of them.

Article 10. Dissemination of information.

Without prejudice to the provisions of Article 8.3, the dissociated information resulting from the statistical exploitation of the register shall be made available to the public health authorities, the managers and the health professionals. and citizens on the terms that are agreed upon in the CISNS, in accordance with the provisions of Article 53.4 of Law 16/2003 of 28 May.

Article 11. Exchange of information in the field of the European Union.

The exchange of data with the institutions of the European Union shall be carried out in accordance with the provisions of Regulation (EC) No 1338/2008 of the European Parliament and of the Council of 16 December 2008 on statistics public health and health and safety at work community.

Additional disposition first. Instruments of collaboration.

It will be possible to subscribe to how many legal instruments might be necessary for the implementation of the registration.

Additional provision second. Efficiency of statistical processes.

For the sake of the efficiency of the statistical processes and in order to reduce the load of the reporting units the organ responsible for the registration will integrate and use the data of the statistical operation number 30123 "Statistics of Health Centers for Specialized Care" in the analysis on the functioning of the National Health System.

Additional provision third. Cities of Ceuta and Melilla.

The references that in this royal decree are made to the autonomous communities will be understood as the National Institute of Health Management in relation to the hospitals and health care centers specialized in the cities of Ceuta and Melilla.

Additional provision fourth. Log start time.

The autonomous communities and, where appropriate, the health centers will initiate the collection of data from the registry in accordance with the provisions of this royal decree in the following deadlines:

Type	Health Center Type [REGCESS Categories(1)]	Dependency(2)	Start
• Hospitalization. • Ambulatory Surgery.	Agudos Hospitals (Categories C1.1 and C1.2).	1 January
• Hospitalization.	• Hospitalization.	Other Hospitals (Categories C1.3 and C1.4).	Public and private centers.	January 1, 2017
• High-complexity outpatient procedures. • Day Hospital Physician. • Home Hospitalization. • Emergencies.	Hospitals (Categories C1.1 and C1.2).	1 January
Ambulatory Surgery. • Procedures High-complexity outpatients. • Medical Day Hospital.		Public Centers.	January 1, 2019
• High-complexity Ambulatory Procedures. • Medical Day Hospital. • Home Hospitalization. • Emergencies.	Agudos Hospitals (Categories C1.1 and C1.2).	Private Centers.	January 1, 2020
• Ambulatory Surgery. • High-complexity Ambulatory Procedures. • Medical Day Hospital.	Specialized Outpatient Centers (C2.5 Categories).	Private Centers.	1 January 2020
(1) Annex I Royal Decree 1277/2003, of 10 October, laying down the general basis for the authorisation of health centres, services and establishments. (2) Public centers include public use network centers and centers with a replacement concert

Additional provision fifth. Creating an automated data file.

In compliance with Organic Law 15/1999 of 13 December and Royal Decree 1720/2007 of 21 December, the person holding the Ministry of Health, Social Services and Equality shall, by order, approve the creation of the automated file of personal data of the registry, within three months from the entry into force of this royal decree.

Additional provision sixth. No increase in public spending.

In accordance with the provisions of the additional twenty-fourth provision of Law 36/2014 of 26 December 2014 of the General Budget of the State for the year 2015, the measures included in this royal decree cannot be assumed increase in appropriations or remuneration and other staff costs.

Single repeal provision. Regulatory repeal.

The Royal Decree 1360/1976, of 21 May, is hereby repealed, whereby the use of a registration book, as well as the provisions of the same or the same or similar provisions, is made compulsory by health establishments lower rank object to the provisions of this royal decree.

Final disposition first. Competence title.

This royal decree has the character of basic legislation and is dictated under the jurisdiction of article 149.1.16. the Spanish Constitution is attributed to the State in the field of bases and general coordination of health.

Final disposition second. Regulatory development.

The head of the Ministry of Health, Social Services and Equality is empowered to dictate how many provisions are necessary for the implementation and development of what is established in this royal decree, as well as for the amendment of its annexes.

Final disposition third. Entry into force.

This royal decree will enter into force on the day following its publication in the "Official State Gazette".

Given in Madrid, on February 6, 2015.

FELIPE R.

The Minister of Health, Social Services and Equality,

ALFONSO ALONSO ARANEGUI

ANNEX I

Definitions of the variables included in the Specialized Health Care Activity Log (RAE-CMBD)

1. Type of Personal Identification code.

This variable refers to the code that is used for the personal identification of the patient.

The possible categories of this variable are:

1) Personal identification code of the Autonomous Community.

2) Single personal identification code of the National Health System included in the Individual Health Insurance Card (TSI).

3) Code of Identification of the General Mutuality of Civil Servants of the State (MUFACE), of the Social Institute of the Armed Forces (ISFAS) and of the General Judicial Mutuality (MUGEJU).

4) European Health Insurance Card Identification Code (TSE).

5) National Identity Document (DNI/NIE).

6) Passport.

2. Personal Identification Code. Corresponds to the patient's individual identifier.

In all contacts whose funding is in charge of the National Health System, either through the Health Services of the Autonomous Communities or the INGESA or through the administrative mutual societies of the regimes Special Social Security (MUFACE, MUGEJU and ISFAS), the corresponding code of categories 1 to 3 of the variable Type of personal identification code will be entered.

In all other cases it will be mandatory to complete this field with the corresponding code of the other categories.

3. Number of medical history. This variable refers to the patient's medical history number in the health center where the contact occurs.

4. Date of birth. This variable collects the date of birth of the patient.

5. Sex. This variable refers to the sex of the patient.

The possible categories of this variable are:

1) Man.

2) Woman.

9) Not specified.

6. Country of birth. This variable refers to the country of birth of the patient.

For completion, the corresponding country ISO Code (listed in Annex II.d) will be used.

7. Postal code of the patient's usual address. This variable refers to the postal code of the patient's usual address and is completed according to the country of residence.

Residents in Spain: It will be of choice the place where six months or more resides and alternatively the place of registration. If it is not possible to fill in the variable with none of the previous options will be reported from the province completing the first two figures for the province (INE code) followed by three zeros.

Residents in foreign countries: 53 followed by the country's ISO code will be used and if the country of residence is unknown, 53000 will be recorded.

8. Municipality of the patient's usual address. This variable is completed by the INE code corresponding to the municipality of the patient's usual address.

Depending on country of residence:

Residents in Spain: It will be of choice the place where six months or more resides and, alternatively, the place of registration. If it is not possible to fill in the variable with none of the previous options will be reported from the province completing the first two figures for the province (INE code) followed by three zeros.

Residents in foreign countries: 530 followed by the country's ISO code will be used and if the country of residence is unknown 530000 will be logged.

9. Financing scheme. This variable refers to the person responsible for the economic financing of the contact costs.

Possible values for this variable are:

1) National Health System (SNS).

2) European regulations and bilateral conventions. This funding scheme refers to healthcare provided to foreign nationals during their stay in Spain, included in the conventions for Community countries and in specific bilateral conventions.

3) Administrative mutual benefits of the special social security schemes of civil servants (MUFACE, ISFAS and MUGEJU). This is the health care provided to the mutualists or beneficiaries belonging to the General Mutuality of Civil Servants of the State, the Social Institute of the Armed Forces and the General Judicial Mutuality who have chosen to receive assistance. health through insurance entities.

4) Mutual Partners with Social Security. It includes healthcare provided in the event of an accident at work or occupational disease when it is in concert with a Mutual Contributor with Social Security.

5) Traffic accidents. It includes healthcare for patients whose contact occurs as a result of a road accident, whether or not the patient is a beneficiary of the SNS.

6) Direct private financing (natural persons). Includes the assistance the user receives from whose payment is responsible himself including private foreigners who are not covered by an International Convention assistance.

7) Financing through private insurance (health insurance companies). It includes the health care of users whose payment is responsible for a third party, including that financed by a compulsory insurance undertaking not covered by the above cases and which includes:

Mandatory insurance excluded from motor vehicles (school insurance, federated and professional sportsmen, travellers, hunting, non-professional taurines, public holidays ...).

Conventions or concerts with other entities or entities, in which the terms of the agreement or concert are not included in other paragraphs.

In no case do you understand the mutualists or beneficiaries belonging to MUFACE, ISFAS and MUGEJU who receive healthcare through insurance entities and who are listed in category 3.

8) Transfrontier Health Care. This funding scheme refers to healthcare provided in a Member State other than the Member State of affiliation as set out in Royal Decree 81/2014 of 7 February, laying down rules to ensure cross-border healthcare, and amending Royal Decree 1718/2010 of 17 December 2010 on medical prescription and dispensing orders.

In no case do you understand the citizens covered by the European regulations and bilateral agreements and which are listed in category 2.

9) Other and unknown.

10. The start date and time of the care. This variable corresponds to the date and time recorded in admission or in the care services of the health center and identifies the arrival of the patient in the care modality.

11. Date and time of the order of entry. This variable refers to the date and time when the hospitalization entry order is cured.

Your fulfillment is unique to the situation of patients who after an initial contact in the "Emergency" mode and without having mediated discharge, enter hospitalization.

12. Type of contact. This variable refers to the provided care mode.

The possible categories of this variable are:

1) Hospitalization: Care taken after a patient's admission to a hospital bed. It is excluded from this modality the dialysis sessions, the day hospital sessions, the care in the emergency observation beds, as well as the stay in the hospital of the healthy newborns and the other contacts of others. care modalities.

The hospitalization contacts will be computed at the hospital discharge.

Non-hospitalization episodes will not be included with zero days of stay except for cases that have ended on the basis of death, transfer, or voluntary discharge.

2) Home hospital: Attention made at the patient's home by the specialized care services. The beginning of the episode will be considered from its date of indication (entry under this modality) until the date of completion of the same under this modality and cause (high in this modality), regardless of its service of origin, of the number of visits made at the address and destination after discharge. The contacts that during the episode of home hospitalization will occur with other outpatient care modalities will be considered included in the same episode whenever they derive from the process that prompted such contact. In case the patient needs to be admitted to a hospital, he will be high in the care modality of home hospitalization.

3) Hospital for a medical day: Care taken, without hospital admission, which specifically includes medical treatments for patients requiring special medical and/or nursing care on a continuous basis several hours (including chemotherapy for oncological and haematological patients when provided on a day-to-day hospital regimen), regardless of the nature of the purpose and destination after the day (home, transfer, hospitalization, etc.).

In the event that the patient has remained in the healthcare facility for more than 24 hours from the beginning of the contact, it will be considered as an episode of "hospitalization" identifying as an applicant for the contact (field Source) "medical day hospital", except where the admission to the hospital is motivated by a complication, in which case it must be recorded as an independent episode consisting of the main diagnosis such complication.

4) Outpatient surgery: Surgical interventions performed under general, local, regional or sedation anesthesia that require low-intensive and short-term postoperative care are considered as such. In the case of hospital admission, the hospital is in need of hospital admission and in which the discharge is scheduled immediately or within a few hours of the intervention. As a reference they will be considered for inclusion in this category and according to the criteria of the Manual of definitions of the Statistics of the Health Centers of Care Specialized all the ambulatory surgical interventions carried out in the operating room.

In the event that the patient has remained in the healthcare facility for more than twenty-four hours, it will be considered as an episode of "hospitalization" identifying as an applicant for the contact (field Provenance). "ambulatory surgery", except where the admission to the hospital is motivated by a complication, in which case it must be recorded as an independent episode, with the main diagnosis being such a complication.

5) Outpatient procedure of special complexity: procedures and activities carried out in specific services and cabinets whose execution involves a high consumption of health resources or which require care in their preparation or in the hours after its completion. Hemodynamics, interventional radiology, bronchoscopy, colonoscopy, retrograde cholangiopancreatography, invasive imaging techniques, hemodialysis, renal lithotrigraphy, and renal function are considered for inclusion in this category. extracorporeal, PET, PET-CT, radiosurgery and stereotaxic radiation therapy.

Procedures will be recorded for patients on an outpatient basis, provided that the contact with the health center has been motivated exclusively for the procedure. Therefore, the procedures performed in patients admitted in the course of such admission to the health center or during a contact in the rest of the care modalities are excluded.

In the event that the patient has remained in the healthcare facility for more than twenty-four hours, it will be considered as an episode of "hospitalization" identifying as an applicant for the contact (field Provenance). 'ambulatory procedure of special complexity', except where the admission to the hospital is motivated by a complication, in which case it must be recorded as an independent episode consisting of the main diagnosis of this complication.

6) Emergency: This modality will include only contacts that occur in hospital emergency services. All patient contacts shall be recorded regardless of their origin and purpose, irrespective of the length of stay, which shall be between the time of arrival and the time of departure of the patient. Emergency care for patients admitted to an inpatient bed is excluded.

In the event that in the course of emergency care the patient must be admitted to a hospital bed in the same health center and/or in the case that he has remained in the service for more than twenty-four years. hours, will be considered as an episode of "hospitalization" identifying as an applicant of the contact (field Provenance) "emergency" being the date of the beginning of the contact the patient's arrival to the emergency department.

13. Type of visit. This variable refers exclusively to the medical-day hospital care modality.

The possible categories of this variable are:

1) Initial contact. Contact in which the patient first comes for a specific process and has not been treated before, or who, having been, had already completed medical discharge with care continuity equal to 1 (not accurate).

2) Successive contact. A contact that occurs after an initial one in the same hospital mode of day, as a consequence of a medical indication of continuity of care, for the same disease process.

9) Unknown.

14. Provenance. This variable refers to the device, health service, or entity requesting the contact.

The possible categories of this variable are:

10) Primary Care.

21) Services of the hospital itself: Emergency.

22) Hospital's own services: Outpatient surgery.

23) Services of the hospital itself: Medical day hospital.

24) Hospital Services: Hospitalization.

25) Services of the hospital itself: Home hospitality.

26) Hospital own services: Outpatient procedures of special complexity.

27) Hospital Services: Consultations.

28) Other services.

30) Services of another hospital/health center.

40) On the initiative of the patient.

50) Medical emergencies (other than hospital services, medical services, and extra-hospital paramedics).

60) Sociohealth Center.

70) By court order.

80) Other.

90) Unknown.

15. Circumstances of the attention. This variable refers to whether the contact had been planned and planned before the time of its realization.

The values that you support are:

1) Unscheduled: Unanticipated contact that arises and is performed unexpectedly for the center/unit.

2) Scheduled: Previously intended contact, which has been arranged in advance for a date and time for completion.

9) Unknown.

16. Service responsible for care. This variable refers to the service responsible for the health care of the contact.

The values of this variable are those included in the list in Annex II.c.

In the case of high-volunteer, deaths or abandonment, the last service in which the patient was admitted will be included.

17. The date and time of the end of the care. This variable refers to the date on which the end of the contact occurs.

Your fulfillment will be performed based on the appropriate care mode.

For episodes of hospitalization and hospitalization at home, the end date of the contact corresponds to the date of discharge.

For medical day hospital modalities, ambulatory surgery, urgency, and outpatient procedures of special complexity, it corresponds to the date/time when the service/modality patient's discharge/discharge is ruled out. care regardless of the time when you effectively leave the center.

18. Type of discharge. This variable refers to the immediate destination of the patient after the care contact.

The possible categories are:

1) Address: When the patient returns to his usual address or when he returns to the center that was his habitual residence before the entry/contact.

2) Transfer to another hospital.

3) High-volunteer: When discharge occurs at the request of the patient himself or when he leaves the center where he was admitted without a medical indication or without knowledge of the hospital.

4) Exitus.

5) Transfer to a social-health center: When the patient moves to a center that replaces the home and has the consideration of social and health care in the area that has the attention.

8) Other.

9) Unknown.

19. Device for continuity of care. This variable refers to the indication of new care in the same health center after initial contact.

It will be completed according to the following categories:

1) Not accurate.

2) Inpatient admission to the hospital itself.

3) Home hospitality.

4) Medical day hospital.

5) Urgences.

6) Queries.

8) Other.

9) Unknown.

20. Date and time of intervention. This variable refers to the date of the surgical intervention in the event that it occurred during the care contact.

It will only be completed in the event that during the contact there has been a surgical intervention or other procedure in which the use of the operating room has been required.

If more than one has been performed, the date of the first one will be recorded.

21. Admission to Intensive Care Unit (ICU). This variable refers to whether during the care contact the patient has required admission to Intensive Care Units.

This variable will be collected exclusively in hospitalization mode.

For completion:

Intensive care units will be considered the specific intensive care units, the coronary units, the large burned units, the neonatal and pediatric intensive care units as well as the post-surgical resuscitation units that have a fixed envelope of beds and in which administrative revenue is made.

No intensive care units will be considered the areas of postoperative resuscitation that have the consideration of observation beds.

Possible values will be:

1) Yes.

2) No.

22. Days of stay in Intensive Care Unit. This variable refers to the days the patient remains in the Intensive Care Unit described in the above variable.

23. Main diagnosis. This variable is defined as the condition that after the necessary study is established that was the cause of the contact with the hospital center.

The encoding of this variable will be performed with the International Classification of Diseases 10. th revision, clinical modification for diagnostics (CIE10ES-diagnoses).

24. POA1 marker of the main diagnosis. The POA1 marker variable of the main diagnosis refers to its classification according to whether it is pre-existing at the time of the entry or is subsequently overcome.

You will adopt the following values:

S. Yes: Present at the time of entry.

N. No: Not present at the time of admission; occurs during hospitalization.

D. Unknown: Insufficient documentation to determine if a process is present or not present.

I. Clinically undetermined: The medical personnel responsible for discharge are not clinically able to determine whether or not the process was present at admission.

E. Exempt from POA placeholder assignment.

Your application will be performed following a guide that will be approved by the Technical Committee of the state CMBD.

25. Secondary diagnoses. These variables are defined as the diagnoses that coexist with the main diagnosis at the time of the contact or that are developed throughout their care and which, in the opinion of the physician, may influence the evolution or treatment of the patient.

The secondary diagnoses will include those related to external causes of injury and poisoning (Codes E).

The encoding of this variable will be performed with the International Classification of Diseases 10. th revision, clinical modification for diagnostics (CIE10ES-diagnoses).

26. POA2 marker for secondary diagnostics. The POA marker variables of the secondary diagnoses refer to their classification according to whether it is pre-existing at the time of the entry or is later exceeded.

You will adopt the following values:

S. Yes: Present at the time of entry.

N. No: Not present at the time of admission; occurs during hospitalization.

D. Unknown: Insufficient documentation to determine if a process is present or not present.

I. Clinically undetermined: The medical personnel responsible for discharge are not clinically able to determine whether or not the process was present at admission.

E. Exempt from POA placeholder assignment.

Your application will be performed following a guide that will be approved by the Technical Committee of the state CMBD.

27. Procedures performed at the centre. These variables refer to those procedures performed in the health center that require specialized material and human resources, which involve a risk to the patient or that, related to the main diagnosis, result in the relevant to your study or treatment.

Coding will be performed with CIE10 for procedures (CIE10ES-procedures).

28. Procedures performed in other centres. These variables refer to those procedures performed in other different centers without having produced the discharge in the hospital of origin and without having entered the center where these procedures are performed.

Coding will be performed with CIE10 for procedures (CIE10ES-procedures).

29. Morphology codes for neoplasms. These variables refer to the morphological description of the neoplasms.

For completion, the coding of the International Classification of Diseases CIE9MC will be used until 2015 and from 1 January 2016 the current version of the International Classification of Diseases for Oncology (CIEO).

30. Health centre. This variable refers to the healthcare facility where healthcare is provided.

For completion it will be used:

For hospitals: the National Hospital Catalog code.

For ambulatory specialized care facilities: the code of the General Register of Health Centers and Establishments (including human reproduction centers, voluntary interruption centers) of pregnancy, ambulatory surgery centres and dialysis centres, categories C252, C253, C254, C255, respectively of the classification of such a register).

31. Autonomous community of the health center. This variable refers to the autonomous community in which healthcare is provided.

For completion, the codes of the Autonomous Communities will be used (Annex II.c).

ANNEX II

RAE-CMBD DATA MODEL

Annex II.a

Exchange file structure

Number

possible values are those set with numbers or letters for each variable and, if applicable, the classifications or reference lists that are listed in the "observations" column.

⁽²⁾ General Registry of Centers Establishments and Health Services Order SCO/3866/2007, of December 18, for which the content and structure of the General Register of health centres, services and establishments of the Ministry of Health and Consumer Affairs

Variable Name	Description	Values(1)	Format	Length	Observations
1	TIP_CIP	Personal Identification Code Type.	1. CA Personal Identification Code. 2. SNS Health Individual Card. 3. European Health Insurance Card. 4. MUFACE/ISFAS/MUGEJU Identification Code. 5. DNI. 6. Passport. 9. Unknown.	Character.	1
2	CIP	Personal Identification Code.					16
3	HISTORY	Number of Clinical History.		Character.	20
4	FECNAC	Date of birth.		Date (ddmmaaaa).	8
5	SEX	Sex.	1. Male. 2. Woman. 9. Not specified.	Character.	1
6	PAIS_NAC	birth country ISO code.				3	ISO Code. If not known, ZZZ will be coded.
7	RESIDE_CP	Home postal code.		Character.	5	53 + ISO country code for residents in foreign.
8	RESIDE_MUNI	Home Municipality Code.		Character.	6	530 + ISO country code for foreign residents
9	REGFIN	Financing Regime.	1. National Health System (SNS). 2. European regulations and bilateral agreements. 3. Mutual societies of state officials and other AAPP. 4. Mutual partners with Social Security. 5. Traffic accidents. 6. Direct private financing (natural persons). 7. Private financing by private insurance (Healthcare insurance companies). 8. Cross-border healthcare. 9. Others and Unknown.	Character.	1
10	FECINICON	Contact start date and time.		Date (ddmmaaaa hhmi).	13	In case of not knowing the time-min record 9999.
11	FECINGHOSP	Date and course time of the patient's order of entry.		Date (ddmmaaaa hhmi).	13	In case of not knowing the time-min record 9999.
12	TIPCONT	Contact type.	1. Hospitalization. 2. Hospitalization at home. 3. Medical day hospital. 4. Outpatient surgery. 5. Outpatient procedures of special complexity. 6. Urgencies. 8. Others.	Character.	1
13	TIPVISIT	Type of the visit.	1. Initial contact. 2. Successive Contact. 9. Unknown.	Character.	1
14	PROVENANCE	Contact Requester.	Primary Care. 21. Services of the hospital itself: Urgences. 22. Hospital services: outpatient surgery. 23. Hospital services: Medical day hospital. 24. Hospital services: Hospitalization. 25. Services of the hospital itself: Hospitalisation at home. 26. Services of the hospital itself: Procedures of special complexity. 27. Hospital services: Consultations. 28. Other services. 30. Services of another hospital/health center. 40. At the patient's initiative. 50. Medical emergencies. 60. Socio-health center. 80. Others. 90. Unknown.	Character.	2
15	CIRCONT	Contact Circumstances	1. Unscheduled. 2. Scheduled. 9. Unknown.	Character.	1
16	SERVICE	Service Code.	View Service Listing in the Annex II.b.	Character.	3
		FECFINCONT	End date and time of contact.		Date (ddmmaaaa hhmi).	13	In case of not knowing the time-min record 9999.
18	TIPALT	Target after contact.	1. Address. 2. Transfer to another Hospital. 3. High volunteer. 4. Exitus. 5. Transfer to the social and health center. 8. Others. 9. Unknown.	Character.	1
19	CONTINUITY device	Care Continuity.	1. Not accurate. 2. Hospitalization in the hospital itself. 3. Hospitalization at home. 4. Medical day hospital. 5. Urgencies. 6. Queries. 8. Others. 9. Unknown.	Character.	1
20	FECNT	Date and Time of Intervention.		Date (ddmmaaaa hhmi).	13	In case of not knowing the time-min record 9999.
21	ICU	1.	1. YES. 2. NO.	Character.	1
22	ICU DIAS_ID	ICU stay days.		Numeric.	3
23	D1	Diagnostic Principal.				7	7
	POAD1	Diagnostic POA Marker principal. Main Diagnostic present at income.	S. YES. N. NO. D. Unknown. I. Undetermined clinically. E. Exempt.	Character.	1
25	D2-D20	Secondary diagnostics (up to a maximum of 19).				7	7 from 1 January 2016)
26	POAD2-POAD20	Diagnostic POA Marker Diagnosis present at income.	S. YES. N. NO. D. Unknown. I. Undetermined clinically. E. Exempt.	Character.	1
27	PROC1-PROC20	Procedures in the center (1 to 20).				7	7 1 January 2016)
	28	PROCESS-PROCESS	Procedures in other centers (1 to 6).		Character.	7	CIE10ES (as of 1 January 2016)
29	M1 M6	Neoplasms morphology (1 to 6).		Character.	7	CIEO (as of January 1, 2016)
	30	CEN_ SAN	Healthcare center.				9
31	CCAA	Autonomous Community.	Annex II.c.			2									(1)

Annex II.b

Services and Units table

Clinical Analysis ACLs.

ACV Angiology and Vascular Surgery.

ADM Admission and clinical documentation.

ALG Allergology.

NRA Anesthesia and Resuscitation.

APA Anatomy Pathology.

BCS Blood Bank.

BIO Biochemistry Clinic.

CAR Cardiology.

CCA Heart Surgery.

CCI Children's Heart Surgery.

CIR General and Digestive Surgery.

CMF Maxillofacial Surgery.

CPE Paediatric Surgery.

CPL Plastic and Repairing Surgery.

CTO Thoracic Surgery.

DCL Clinical Documentation.

DER Dermatology.

Dietary DIE.

Digestive DIG.

END Endocrinology.

EST Estomatology.

FAC Clinical Pharmacology.

FAR Pharmacy.

Genetical GEN.

Geriatrics GRT.

HEL Laboratory Hematology.

HEM Clinical Hematology.

INF Infectious diseases.

INM Immunology.

LAB Laboratories.

LIT Litotricia.

MFC Family and Community Medicine.

MIC Microbiology and Parasitology.

MIN Neonatal Intensive Medicine.

MIP Pediatric Intensive Medicine.

MIR Internal Medicine.

MIV Intensive Medicine.

MNU Nuclear Medicine.

MPR Preventive Medicine.

NEF Nephrology.

NEO Neonatology.

NFC Clinical Neurophysiology.

NML Pneumonia.

NRC Neurosurgery.

NRL Neurology.

OBG Obstetrics and Gynecology.

OFT Ophthalmology.

ONC Medical Oncology.

ONR Radioterapic Oncology.

ORL Otorhinolaryngology.

OTR Other.

PED Paediatrics.

PSQ Psychiatry.

RAD Radiology.

RAI Interventional Radiology.

RDT Radiotherapy.

REH Rehabilitation.

REU Rheumatology.

TRA Traumatology and C. Orthopaedic.

UCE Short Stay Unit.

UCP Palliative Care Unit.

UCR Coronary Unit.

UDO Pain Unit.

UHD Hemodialysis Unit.

ULE Long Stay Unit.

ULM Medular Injured Unit.

URGES URG.

URH Human Reproduction Unit.

URO Urology.

USE Sleep Unit.

UTR Extraction and Transplant Units.

UTX Detox Unit.

Annex II.c

Autonomous Communities Code Table

1 Andalusia.

2 Aragon.

3 Asturias (Principality of).

4 Balears (Illes).

5 Canarias.

6 Cantabria.

7 Castilla y León.

8 Castilla-La Mancha.

9 Catalonia.

10 Valencian Community.

11 Extremadura.

12 Galicia.

13 Madrid (Community of).

14 Murcia (Region of).

15 Navarra (Foral Community).

16 Basque Country.

17 Rioja (La).

18 Ceuta.

19 Melilla.

Annex II.d

Country ISO Code Table⁽¹⁾

004

028

040

608

Numeric code	Name	Numeric code	Name
Afghanistan.	096	Brunei.
	248	100		Bulgaria.
	008	Albania.	854	Burkina Faso.
276	Germany.	108	Burundi
020	Andorra.	064	024
Angola.	132	132	132	Green table_to_izq"> Cape Verde.
660
120	Cameroon
	682	Saudi Arabia.	124	012
Algeria.	634	032
Argentina.	535	Caribbean.
051	Armenia.	148	Chad.
533			Chile.
	036	Australia.	156	China.
Austria.	196	031
	.	170	Colombia.
044				050
	408
	052		410
048	Bahrain.	384	056
Belgium.	188	188	188	Zant_table_izq"> Costa Rica
084	191		Croatia.
204	192		Cuba.
	060	Bermuda.	531	112
Belarus.	208	208	208	208	208	Denmark.
	Burma.	212	Dominica
068	Bolivia.	218	Ecuador.
070	818	Egypt.
	072	Botswana.	222	El Salvador.
076	Brazil.	784		232
344
344	344	Hong Kong.
703	Slovakia.	348	Hungary.
705	Slovenia.	356	India.
724	Spain.	360
	368	368	Iraq.
	233	Estonia.	364
	231	372	372	Ireland
833		Isle of Man
	246	Finland.	574	242
.	352	352	352	352		250
	.	136	136		266
	266		184
		234
	268	Georgia.	238		288
Ghana.	580	580	580	580	North Mariana Islands-table_table_izq"> The Northern Mariana Islands
	292	Gibraltar.	584	Marshall Islands.
308	Granada.	612	Pitcairn Islands.
300	Greece.	090	Solomon Islands.
304	Greenland.	796	Turkish and Caicos Islands.
312	Guadalupe.	581	U.S. ultramarine islands
316	Guam.	092	BVI.
320	Guatemala.	850	U.S. Virgin Islands.
254	French Guiana.	376	Israel.
831	Guernsey.	380	Italy.
324	Guinea.	388	Jamaica.
624	Guinea-Bisau.	392	Japan.
226	Equatorial Guinea.	832	Jersey.
328	Guyana.	400	Jordan.
332	Haiti.	398	Kazakhstan.
	340	Honduras.	404	Kenya.
	Kyrgyzstan.	500	Montserrat
296	Kiribati.	508	Mozambique.
414	Kuwait.	516	Namibia.
418	Laos.	520	Nauru.
	Lesotho.	524	Nepal.
428	Latvia.	558	Nicaragua.
422	Lebanon.	562	Niger.
430	Liberia.	566	Nigeria.
434	Libya.	570	Niue.
	438	Liechtenstein.	578	Norway.
440	Lithuania.	540	New Caledonia.
442	Luxembourg.	554	New Zealand.
446	Macau.	512	Oman.
450	Madagascar.	528	Netherlands.
	458	Malaysia.	586	Pakistan.
	454	Malawi.	585	Palaos.
462	Maldives.	275	Palestine State
466	Mali.	591	Panama.
470	Malta.	598	Papua New Guinea.
	504	Morocco.	600	Paraguay.
474	Martinique.	604	Peru.
480	Mauritius.	258	French Polynesia.
478	Mauritania.	616	Poland.
175	Mayotte.		620	Portugal.
	Mexico.	630	Puerto Rico.
583	Micronesia.	826	UK.
498	Moldova.	140	Central African Republic.
492	Monaco.	203	Czech Republic.
496	Mongolia.	807	Republic of Macedonia.
	Montenegro.	178	Republic of Congo.
180	Democratic Republic of Congo.	728
214	Dominican Republic.	752	Sweden.
638	Meeting.	756	Switzerland.
646	Rwanda.	740	Suriname.
642	Romania.	744	Svalbard and Jan Mayen.
643	Russia.	764	Thailand.
732	Western Sahara.	834	Tanzania.
882	Samoa.	762	Tajikistan.
	016	626	East
		652		652	San Bartolome.	768	Togo.
659	San Cristobal and Nevis.	772	Tokelau.
674	San Marino.	776	Tonga.
663	San Martin.	780	Trinidad and Tobago.
666	San Pedro and Miquelon.	788	Tunisia.
670	St. Vincent and the Grenadines.	795	Turkmenistan.
654	St. Helena, A. and T.	792	Turkey.
	662	Saint Lucia.	798	Tuvalu.
678	São Tomé and Príncipe.	804	Ukraine.
686	Senegal.	800	Uganda.
688	Serbia.	858	Uruguay.
690	Seychelles.	860	Uzbekistan.
	694	Sierra Leone.	548	Vanuatu.
702	Singapore.	336	Vatican City.
534	Sint Maarten.	862	Venezuela.
760	Syria.	704	Vietnam.
706	Somalia.	876	Wallis and Futuna.
	144	Sri Lanka.	887	Yemen.
748	Swaziland.	262	Djibouti
710	South Africa.	894	Zambia.
729	Sudan.	716	Zimbabwe.
ZZZ	Unknown.
				(1) ISO 3166 Standard, International Organization for Standardization, in its version ISO 3166-1 (alphanumeric code, three digits), corresponds to that defined by the United Nations Statistical Division