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Z Orthop Unfall. 2013 Feb;151(1):20-4. doi: 10.1055/s-0032-1328206. Epub 2013 Feb 19.

[Significant reduction of osteoporosis fracture-related hospitalisation rate due to intensified, multimodal treatment - results from the Integrated Health Care Network Osteoporosis North Rhine].

[Article in German]

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Orthopädische Praxis, Heinsberg.



Osteoporosis is known as being undertreated in Germany. The aim of the integrated health care model "osteoporosis" was the improvement of patient care by multimodal treatment within an integrated health care network. This paper shows the results of the accompanying evaluation.


A retrospective cross-sectional analysis was performed using routine data from the AOK Rheinland/Hamburg for the years 2007-2010. Patients were included if they were 50-89 years old and had a diagnosis of osteoporosis (ICD-10 M80 or M81) and at least three prescriptions of osteoporosis-specific medication. Data were analysed separately for integrated health care and regular health care.


22 040 patients were detected, thereof 3173 patients in the integrated health care group (IV). The hospitalisation rate for hip fractures was significantly lower in the IV group: 5.93/1000 patient years versus 22.96/1000 patient years (- 74 %, p < 0.05). Also the hospitalisation rate of all other osteoporosis-related fractures was reduced by 73 %: 46.92/1000 patient years versus 172.88/1000 patient years (p < 0.05). Osteoporosis-related medication costs were doubled in the IV group, while total medication costs were lower in the IV group (1438 € vs. 1702 €).


This observational, cross-sectional study shows that an intensified, multimodal treatment of osteoporosis within an integrated health care network of highly qualified physicians can reduce the hospitalisation rate due to osteoporosis-associated fractures and simultaneously reduce direct costs even in the short term.

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