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Archives of Osteoporosis
Published in: Archives of Osteoporosis 1/2015

01-12-2015 | Original Article

Swedish osteoporosis care

Authors: Emma Jonsson, Daniel Eriksson, Kristina Åkesson, Östen Ljunggren, Stina Salomonsson, Fredrik Borgström, Oskar Ström

Published in: Archives of Osteoporosis | Issue 1/2015

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Summary

Mini-abstract

The objective of this study was to review and describe the current state of Swedish osteoporosis care and to highlight ongoing challenges. This report encompasses quantitative health outcomes based on Swedish registry data as well as organizational and management aspects.

Executive summary

Swedish osteoporosis care is characterized by a significant burden of disease, difficulties in identifying high-risk patients, and fragmented pathways for patients in need of secondary fracture prevention. This report aimed to describe the current state, gaps, and challenges in Swedish osteoporosis care, using Swedish national databases, questionnaires, and interviews with healthcare representatives. A secondary aim was to develop quality and process measures to compare differences between counties and to use those measures to describe the interaction between quantitative health outcomes and aspects of care organization and management. In conjunction with fractures, a considerably smaller proportion of men are treated than women, and a smaller proportion of older women are treated compared to younger groups. Between 3 and 16 % of patients receive treatment after a fracture, and the treatment rate in this patient group can likely increase. In addition to an unsatisfactory treatment rate, a limited number of those treated continue treatment throughout the recommended treatment durations, leading to increased risk of fracture. With a substantial variation between counties, there is a clear difficulty to identify non-persistent patients and switch to an alternative treatment. Collaboration around the patient across specialties has been lacking, and systems for secondary prevention have been concentrated to a few counties. However, when this study was conducted, there was a general trend towards implementing regional care programs. This report suggests possible strategies for improving quality of care and, hopefully, it can provide a basis for future evaluations and regional improvement of osteoporosis care in Sweden and other countries.
Appendix
Available only for authorised users
Footnotes
1
This report defines major osteoporotic fracture in the same way as in Quality and Efficiency in Swedish Healthcare; ICD-10 S32.1-8, S52.5-6, S42.2-3, S72.0-4, S22.x, S82.1.
 
2
Only patients with a first care occasion in inpatient care for any of the defined diagnosis codes are included.
 
3
For example, in the report “Unequal conditions for health and healthcare” [Ojämna villkor för hälsa och vård: Jämlikhetsperspektiv på hälso- och sjukvården”], the National Board of Health and Welfare reports challenges in certain healthcare areas where national guidelines are in place [59].
 
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Metadata
Title
Swedish osteoporosis care
Authors
Emma Jonsson
Daniel Eriksson
Kristina Åkesson
Östen Ljunggren
Stina Salomonsson
Fredrik Borgström
Oskar Ström
Publication date
01-12-2015
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2015
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-015-0222-7

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