Graph View

ActorsStandardsResourcesGovernance

LogoLogo

SNDS — Système National des Données de Santé

Overview

The Système National des Données de Santé (SNDS) is the French national health data system, created by the Law of 26 January 2016 (loi de modernisation du système de santé, article 193). It consolidates health insurance reimbursement data (SNIIRAM), hospital discharge records (PMSI), causes of death (CépiDC), and disability data (MDPH/CNSA) for over 65 million people, covering virtually the entire French population. Since the decree of 29 June 2021, CNAM (Caisse Nationale de l’Assurance Maladie) and the Health Data Hub are joint data controllers (responsables conjoints de traitement) of the SNDS, with CNAM managing the core infrastructure and the HDH facilitating project-based access. It is a central resource for large-scale epidemiological, pharmacoepidemiological, and health policy research in France, and under the EHDS it is one of the principal datasets that will be accessed through the Health Data Hub, France’s expected Health Data Access Body for secondary use.

Scope and Coverage

The SNDS covers approximately 99% of French residents, with longitudinal follow-up possible from 2003 onwards. Since October 2022, a larger representative sample called the ESND (Échantillon des données du SNDS) is available for lighter research use, replacing the earlier EGB at 1/97th of the population. Its four main components are health insurance reimbursement data (SNIIRAM, covering ambulatory consultations, prescriptions, medical acts, biological tests, and devices), hospital stay records (PMSI, covering diagnoses, procedures, and GHM groupings across acute care, rehabilitation, home hospitalisation, and psychiatry), cause-of-death data (CépiDC), and disability data (MDPH/CNSA, with partial linkage to the rest of the SNDS).

Data Access

Access is regulated under the French Code de la Santé Publique (articles R. 1461-1 onwards) and overseen by CNAM, the Health Data Hub, and CNIL. Three routes exist. Permanent access is granted by decree to specific public bodies with a public health or research mission (such as CNAM, DREES, Santé publique France, HAS, and ANSM), which query the data directly via CNAM’s secure environment. Project access for academic and industry researchers requires a favourable opinion from CESREES, an authorisation from CNIL, and submission via the Health Data Hub portal, with processing in the HDH Datalab, a secure environment from which no data can be exported. Simplified access is available via CNIL reference methodologies, notably MR-007 for non-interventional studies reusing already-collected data, allowing a conformity declaration in place of full CNIL authorisation for pre-approved study types. Data in the SNDS is pseudonymised but not anonymised, and re-identification of individuals is strictly prohibited.

Coding and Terminologies

Diagnoses in PMSI and CépiDC are coded using CIM-10 (ICD-10) and hospital procedures using CCAM. Ambulatory professional acts use NGAP and reimbursed biological acts use NABM, two French national nomenclatures. Dispensed drugs are identified via CIP and CIS codes, which can be linked to the ATC classification through drug reference databases. Hospital stays in PMSI-MCO are grouped using GHM (Groupes Homogènes de Malades), the French DRG equivalent.

Standards and Interoperability

The Health Data Hub is working on transforming SNDS extracts to OMOP CDM to support federated research, a project-level mapping initiative rather than a native SNDS standard. HL7 FHIR is promoted by ANS (Agence du Numérique en Santé) for future health system interoperability but is likewise not the native format of SNDS. Under the EHDS, which requires member states to designate Health Data Access Bodies by March 2027, the Health Data Hub is France’s expected HDAB, through which the SNDS will be made available for secondary use.

Connections

  • relatedTo: Health Data Hub (joint data controller; manages researcher access through the HDH Datalab, and is France’s expected EHDS Health Data Access Body)
  • relatedTo: CNIL (CNIL authorises project-based access to the SNDS)

Resources

Graph View

ActorsStandardsResourcesGovernance

Tags

Backlinks