National data

Études PMSI / eSND Studies

Leverage national medico-administrative data for your epidemiological, health economics, and pharmacoepidemiological studies.

20+
Years of history
4
PMSI fields
MR-006
PMSI regulatory framework
HDH
Simplified eSND access

PMSI in detail

The Programme de Médicalisation des Systèmes d'Information (PMSI) records all French hospital activity across 4 complementary fields.

MCO

Medicine, surgery, obstetrics, and odontology. The primary field covering acute hospital stays with ICD-10 diagnoses and CCAM procedures.

Diagnoses · Procedures · GHM/GHS

SSR

Follow-up and rehabilitation care. Post-hospitalisation rehabilitation stays with specific coding of impairments and dependencies.

Rehabilitation · Dependency

HAD

Home hospitalisation. Hospital-level care delivered at the patient's home, with tracking of care modes and diagnoses.

Home care · Follow-up

Psychiatry

Mental health institutions. Psychiatric activity data for full or partial inpatient stays, with diagnostic coding.

Mental health · Stays

PMSI data: access via ATIH

The pharmaceutical industry accesses exhaustive PMSI data through the CNIL reference methodology MR-006. Data are processed within the secure CASD environment.

MR-006

Regulatory framework

MR-006 is the CNIL reference methodology governing access to PMSI data by healthcare industry players. It allows a compliance declaration without an individual authorisation.

Scope: exhaustive hospital data (MCO, SSR, HAD, PSY).
Procedure: MR-006 compliance declaration with the CNIL.
Extracting body: ATIH (Agence Technique de l'Information sur l'Hospitalisation).
Data: stays, ICD-10 diagnoses, CCAM procedures, GHM/GHS, length of stay.
CASD

Processing environment

PMSI data are processed within the CASD (Centre d'Accès Sécurisé aux Données), a public-interest group offering a highly secure environment for processing confidential data.

Infrastructure: SD-Box (secure remote access to the CASD infrastructure).
Security: in-situ processing; no extraction of personal data is possible.
Outputs: only aggregated, anonymised results can be exported.
Traceability: full audit trail of accesses and processing operations.
Process

From request to analysis

Access to PMSI data follows a structured process, from protocol drafting to data analysis within the secure CASD environment.

Step 1: drafting the protocol and requirements document.
Step 2: MR-006 compliance declaration with the CNIL.
Step 3: data order placed with ATIH.
Step 4: data made available at CASD and secure analysis.
Clinityx

Our support

Clinityx manages the entire process: scientific scoping, regulatory file, data order from ATIH, analysis at CASD, and deliverable production.

Expertise: in-depth knowledge of the PMSI data model and CASD environment.
Algorithms: library of validated identification algorithms (ICD-10, CCAM).
Timeline: support to optimise data acquisition timelines.
Deliverables: study report, publication, HAS dossier.

eSND: the national sample

The eSND is a representative 1-in-50 sample of the French population, combining hospital data and outpatient care. It benefits from a simplified access procedure via the Health Data Hub.

eSND

A representative national sample

The eSND replaced the former EGB (Échantillon Généraliste de Bénéficiaires) in 2022. It provides a 1-in-50 (2%) population sample, linking outpatient data (DCIR) with hospital data (PMSI).

Population: ~1.3 million representative beneficiaries.
Scope: linked DCIR + PMSI + CépiDC.
Advantage: complete care pathways (outpatient + hospital + mortality).
Limitations: sample-based (limited statistical power for rare conditions).
Simplified procedure

Access via the Health Data Hub

The eSND benefits from a simplified access procedure, with no individual CNIL authorisation required, subject to compliance with conditions defined by the CNIL.

Body: Health Data Hub (instruction and data provision).
Procedure: simplified request, no CESREES or CNIL review required.
Timeline: significantly faster than other access routes.
Conditions: justification of historical depth and use of identifiers.
Use cases

When to use the eSND?

The eSND is particularly suited to exploratory studies, feasibility analyses, and studies on common conditions where a 2% sample provides sufficient statistical power.

Feasibility studies: cohort sizing and statistical power estimation.
Care pathways: longitudinal analysis of outpatient-hospital trajectories.
Pharmacoepidemiology: treatment use and therapeutic lines.
Burden of disease: care costs including outpatient and hospital.

Types of studies available

PMSI and eSND data cover a broad spectrum of real-world studies, from descriptive epidemiology to health economic evaluations.

Descriptive epidemiology

Incidence, prevalence, characterisation of target populations. Identification and sizing of cohorts at national scale using identification algorithms.

Health economics studies

Care costs, burden of disease, budget impact. Hospital stay valuation via GHS and analysis of outpatient care consumption.

Pharmacoepidemiology

Real-world treatment use, lines of therapy, persistence and adherence. Post-marketing safety studies and therapeutic strategy comparisons.

Care pathways

Longitudinal analysis of patient trajectories between outpatient and hospital settings. Identification of care gaps and management delays.

Comparative studies

Comparison of therapeutic strategies under real-world conditions. Analyses using propensity scores, matching, and causal methods on observational data.

Market access dossiers

Real-world data for HAS dossiers (ASMR/SMR), CEPS negotiations, and post-listing studies requested by authorities.

How Clinityx supports you

Clinityx manages the entire process: scientific scoping, regulatory file preparation, data ordering, and analysis within the appropriate secure environment.

For PMSI, we manage the order with ATIH and analysis at CASD. For eSND, we instruct the request with the Health Data Hub via the simplified procedure.

1

Scientific scoping

Definition of the study protocol, objectives, and required data scope. Choice of source (exhaustive PMSI or eSND).

2

Regulatory file

PMSI: MR-006 compliance declaration with the CNIL. eSND: request via the Health Data Hub simplified procedure.

3

Data order and provision

PMSI: order placed with ATIH, data made available at CASD. eSND: instruction by HDH and sample provision.

4

Data analysis

Development of identification algorithms, cohort structuring, and statistical analyses in the secure environment (CASD for PMSI).

5

Deliverables

Production of aggregated and anonymised results: study report, scientific publication, market access dossier (HAS/CEPS).

Our value proposition

A unique expertise combining mastery of national data, data engineering, and end-to-end regulatory support.

Data mastery

In-depth knowledge of French medico-administrative data, built across numerous studies.

  • In-depth knowledge of the PMSI and eSND data models
  • Library of validated identification algorithms (ICD-10, CCAM, ATC)
  • Mastery of the CASD environment
  • Handling of specificities (T2A, duplicates, multi-unit stays)

Regulatory support

Full management of the authorisation process, from protocol design to data provision.

  • MR-006 compliance for PMSI access via ATIH
  • Simplified HDH procedure for eSND
  • Protocol drafting and DPIA preparation
  • Authorisation tracking and timeline optimisation

Analyses and deliverables

Production of robust studies, from cohort construction to deliverable writing.

  • Analyses in SAS, R, and Python
  • Advanced methods (propensity score, IPTW, matching)
  • Scientific publications and market access dossiers
  • Study reports compliant with HAS/CEPS requirements

PMSI or eSND?

Two complementary data sources, each suited to different needs in terms of scope, exhaustiveness, and access timeline.

CriterionPMSI (MR-006)eSND (simplified proc.)
Scope Hospital data Linked sample (DCIR + PMSI + CépiDC)
Population Exhaustive (all hospitalisations) ~1.3M beneficiaries (2% sample)
Body ATIH Health Data Hub
Regulatory framework MR-006 compliance HDH simplified procedure
Processing environment CASD HDH platform
Care pathways Hospital only Complete (outpatient + hospital)
Outpatient medications No Yes (DCIR)
Causes of death No Yes (CépiDC)
Access timeline 2 to 4 months A few weeks
Typical use cases Hospital epidemiology, burden of disease, DRG analysis Exploratory studies, feasibility, care pathways

Launch your PMSI / eSND study

From protocol design to results delivery, Clinityx supports you throughout the entire process.