{
 "schema_version": 1,
 "metric_id": "I5",
 "name": "Hospital waiting times beyond the Treeknorm",
 "domain": "I",
 "tier": "v1",
 "grade": "C",
 "frequency": "A",
 "harmonized_international": false,
 "caveats": "Three reporting regimes that must not be compared: voluntary collection by Mediquest (2010-2018), voluntary NZa reporting (2019-2020), and mandatory biweekly NZa reporting from August 2021. The headline series starts 2021; the 2020->2021 jump in the older companion lines is mostly the expanded provider pool, and the 2021 figure covers August-December only. A share of provider-treatment combinations over the norm is not a share of patients waiting too long. GGZ waiting times are a separate, still-maturing collection.",
 "methodology_notes": "Verified 9 Jul 2026 from the RIVM vzinfo prestatie-indicator page (embedded chart data; the NZa Zorgbeeld API at zorgbeeld.nza.nl/openapi/WaitingTimeMSZ carries only the current snapshot, not the history). Share of provider-treatment combinations in medisch-specialistische zorg whose reported waiting time exceeds the Treeknorm (behandeling 6 weeks; polikliniek/diagnostiek 4 weeks). Reported figure per NZa regeling NR/REG-2421 art. 1 (read first-hand 17 Jul 2026): behandeling = MEDIAN of rekenkundige wachttijden per treatment (<5 observations suppressed), NOT an average; polikliniek/diagnostiek = days until the third available agenda slot. Headline: behandeling, mandatory era (2021: 42.9% -> 2025: 42.0%); companions: polikliniek and diagnostiek (mandatory era) and the two pre-2021 behandeling regimes. Annual refresh ~February from the same page.",
 "owner_review_required": false,
 "sources": [
  {
   "org": "manual:NZa/RIVM",
   "dataset_code": "manual:I5",
   "url": "https://www.vzinfo.nl/prestatie-indicatoren/uitvoering-van-zorg-en-preventie/toegankelijkheid/wachttijden",
   "licence": "NZa WOO waiver (public domain) / RIVM vzinfo publication"
  }
 ],
 "breaks": [
  {
   "period": "2019",
   "note": "Collection moved from Mediquest to NZa (still voluntary) — different provider pool"
  },
  {
   "period": "2021",
   "note": "Reporting mandatory from Aug 2021; 2021 covers Aug–Dec only. The jump from 2020 is mostly the expanded provider pool"
  }
 ],
 "primary": {
  "key": "manual:NZa/RIVM|manual:I5|NL|%|care_type=behandeling,era=nza_mandatory",
  "dataset_code": "manual:I5",
  "source_org": "manual:NZa/RIVM",
  "geography": "NL",
  "unit_code": "%",
  "dimensions": {
   "care_type": "behandeling",
   "era": "nza_mandatory"
  },
  "frequency": "A",
  "points": [
   {
    "period": "2021",
    "value": 42.9,
    "status": "b"
   },
   {
    "period": "2022",
    "value": 46.2
   },
   {
    "period": "2023",
    "value": 46.0
   },
   {
    "period": "2024",
    "value": 43.6
   },
   {
    "period": "2025",
    "value": 42.0
   }
  ]
 },
 "series": [
  {
   "key": "manual:NZa/RIVM|manual:I5|NL|%|care_type=behandeling,era=mediquest_voluntary",
   "dataset_code": "manual:I5",
   "source_org": "manual:NZa/RIVM",
   "geography": "NL",
   "unit_code": "%",
   "dimensions": {
    "care_type": "behandeling",
    "era": "mediquest_voluntary"
   },
   "frequency": "A",
   "points": [
    {
     "period": "2010",
     "value": 19.4
    },
    {
     "period": "2011",
     "value": 16.6
    },
    {
     "period": "2012",
     "value": 15.4
    },
    {
     "period": "2013",
     "value": 13.5
    },
    {
     "period": "2014",
     "value": 13.0
    },
    {
     "period": "2015",
     "value": 13.0
    },
    {
     "period": "2016",
     "value": 14.1
    },
    {
     "period": "2017",
     "value": 17.7
    },
    {
     "period": "2018",
     "value": 24.0
    }
   ]
  },
  {
   "key": "manual:NZa/RIVM|manual:I5|NL|%|care_type=behandeling,era=nza_mandatory",
   "dataset_code": "manual:I5",
   "source_org": "manual:NZa/RIVM",
   "geography": "NL",
   "unit_code": "%",
   "dimensions": {
    "care_type": "behandeling",
    "era": "nza_mandatory"
   },
   "frequency": "A",
   "points": [
    {
     "period": "2021",
     "value": 42.9,
     "status": "b"
    },
    {
     "period": "2022",
     "value": 46.2
    },
    {
     "period": "2023",
     "value": 46.0
    },
    {
     "period": "2024",
     "value": 43.6
    },
    {
     "period": "2025",
     "value": 42.0
    }
   ]
  },
  {
   "key": "manual:NZa/RIVM|manual:I5|NL|%|care_type=diagnostiek,era=nza_mandatory",
   "dataset_code": "manual:I5",
   "source_org": "manual:NZa/RIVM",
   "geography": "NL",
   "unit_code": "%",
   "dimensions": {
    "care_type": "diagnostiek",
    "era": "nza_mandatory"
   },
   "frequency": "A",
   "points": [
    {
     "period": "2021",
     "value": 25.6,
     "status": "b"
    },
    {
     "period": "2022",
     "value": 26.0
    },
    {
     "period": "2023",
     "value": 27.7
    },
    {
     "period": "2024",
     "value": 28.9
    },
    {
     "period": "2025",
     "value": 32.6
    }
   ]
  },
  {
   "key": "manual:NZa/RIVM|manual:I5|NL|%|care_type=polikliniek,era=nza_mandatory",
   "dataset_code": "manual:I5",
   "source_org": "manual:NZa/RIVM",
   "geography": "NL",
   "unit_code": "%",
   "dimensions": {
    "care_type": "polikliniek",
    "era": "nza_mandatory"
   },
   "frequency": "A",
   "points": [
    {
     "period": "2021",
     "value": 41.1,
     "status": "b"
    },
    {
     "period": "2022",
     "value": 44.5
    },
    {
     "period": "2023",
     "value": 47.5
    },
    {
     "period": "2024",
     "value": 49.1
    },
    {
     "period": "2025",
     "value": 50.6
    }
   ]
  },
  {
   "key": "manual:NZa/RIVM|manual:I5|NL|%|care_type=behandeling,era=nza_voluntary",
   "dataset_code": "manual:I5",
   "source_org": "manual:NZa/RIVM",
   "geography": "NL",
   "unit_code": "%",
   "dimensions": {
    "care_type": "behandeling",
    "era": "nza_voluntary"
   },
   "frequency": "A",
   "points": [
    {
     "period": "2019",
     "value": 27.7
    },
    {
     "period": "2020",
     "value": 31.9
    }
   ]
  }
 ],
 "peers": [],
 "derived": [],
 "trend": {
  "direction": "flat",
  "method": "OLS over last 8 annual observations, 5% significance (MBW convention)",
  "window_start": "2021",
  "window_end": "2025",
  "slope_per_year": -0.44
 },
 "deltas": {
  "y1": -1.6,
  "latest_period": "2025",
  "latest_value": 42.0
 },
 "revisions_since": "2026-07-09",
 "generated_at": "2026-09-04T08:06:56+00:00"
}