EU Osteoporosis Report AUSTRIA
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1 EU Osteoporosis Report AUSTRIA Completed by: Prof. Dr. Gerold Holzer, Medical University of Vienna Hon. Prof. Dr. Robert Schlögel, Federal Ministry of Health, Family and Youth, Head, Health Prevention Dr. Inez Stamm, Federal Ministry of Health, Family and Youth OVERVIEW * Ref: Osteoporosis in the European Community: A Call to Action, v 2001 IOF publication ** Ref: Osteoporosis in Europe: Indicators of Progress, Feb 2005, IOF publication *** Ref: Osteoporosis in Europe: Indicators of Progress, Feb 2005, IOF publication National population 8,110,244* 8,233,306 (2005 Statistik Austria) Population over 50 Women:1, (2005 Statistik Austria) Men: 1, (2005 Statistik Austria) Total: 2,794,657 Total (2001): 2,666,831* Number of hip fractures in ,000 * 15 per 10,000 population Number of hip fractures in ,272 (2005 Statistik Austria) 19.7 per 10,000 population Individual hospital cost of hip fracture: Acute care: 8, (15,855 patients) (Statistik Austria) Acute + rehabilitation : 11, (417 patients) Total cost/hip fracture Average number of hospital days in acute care Cost/day (Euro) 11, /hip fracture 16,2 days 487,60 per day (2005 Statistik Austria)
2 Average number of days in rehabilitation or long term care Cost/day (Euro) 23,0 days 137,50 per day (2005 API) Total direct hospital costs of hip fractures 156,000, ,192,094 Number of diagnostic scanners (DXA) per million population Recommended: per million population 220 scanners 26.7 per million (data from major companies) Waiting time for DXA scan in the public 4-2 weeks 1-2 weeks health system Cost for DXA scan of hip and spine Public: free 35,00 Private: 70 *How many DXA scans are carried t recorded 58,280 in private offices out/year? DXA reimbursement (public system) * criteria for reimbursement Public: full reimbursement Private: approximately 50% reimbursed by health insurance companies Reimbursement of proven therapies Full reimbursement (2005 MAASS) Reimbursement with restrictions: Those at high risk = age>65, previous fracture, diseases related to bone loss ie corticosteroid treatment or chemotherapy. 2
3 8 RECOMMENDATIONS 2001 Audit* *Osteoporosis in the European Community: A Call to Action. IOF publication - vember Report 1. IS OSTEOPOROSIS A PRIORITY? 1:a Has your government made osteoporosis a national health priority? t a National Health Priority 1:b Has your government supported national or regional osteoporosis campaigns? EU Summit Conference 2005 Campaign during EU Presidency in :c Do national initiatives advance or restrict the cause? 3
4 2. FRAGILITY FRACTURE STATISTICS 2:a Has a national fragility fracture International coding system Coding system to record hip fractures (ICD 10) registry been established for data collection and monitoring? 2:b If so, give dates for data 2005 Statistik Austria 2:c Is collected data from general or General selected populations? 2:d Incidence rates for hip fracture for men & women over 50 years (per 10,000 population) 2:e Prevalence rates for vertebral fracture for men & women over 50 years (per 10,000 population) 2:f Incidence and/or prevalence of wrist and other non-vertebral fracture for men & women over 50 years Overall: 56,02 (male: 31,07, f: 76,07) t available t available 3. CO-OPERATION AND FUNDING 3:a Which partners have been supportive of your osteoporosis efforts? (corporate, allied health, government) Give specifics 3:b Did these partners collaborate on mutual goals & objectives? 4. Pharma, milk organizations, state funding Few programs supported by corporations and, governments CALCIUM AND VITAMIN D 4
5 4:a Is there a national public health program? 4:b Are there national guidelines on optimum daily intake? 5. ACCESS TO BONE DENSITOMETRY SYSTEMS 5:a Number of hip & spine DXA units (per million population) 5:b Is the distribution of services equitable throughout your country? Healthy School 11 26,7 Mostly in cities (distribution satisfactory) 5:c Cost of DXA (public and private health systems) 5:d Utilization of scans: Public Private 5:e Are diagnostic procedures (DXA) reimbursed? If yes, what are the criteria for reimbursement? 5:f Average wait time for DXA (public and private systems) 5:g Quality Assurance: is there standardized training of technologists? Public: free Private: 70 Public: charge Public: no charge Private: 50% reimbursed Public: 4-12 weeks Private: 4-12 weeks 35,00 About 1/3 public 2/3 private Reimbursement with restrictions: Those at high risk = age>65, previous fracture, diseases related to bone loss ie corticosteroid treatment or chemotherapy. 1-2 weeks Physicians and healthcare professionals are ISCD trained, not necessary for technicians. 5
6 6. PREVENTION, TREATMENT AND REIMBURSEMENT 6:a Do evidence based guidelines exist on prevention, diagnosis and treatment? (if yes, give date & link to publication) 6:b What approved drug therapies are available? 6:c Are the most effective treatments reimbursed? What is the criteria for reimbursement? 6:d Are patients at high risk for fractures eligible for treatment reimbursement BEFORE the first fracture? 6:e Do lifestyle prevention programs exist? 7. THE NGO SECTOR AND TRAINING HEALTHCARE PROFESSIONALS 7:a Has the government supported (financially or through public information) patient and scientific societies? 7:b Do appropriate training programs exist for health professionals? Austrian Society for Bone and Mineral Research Reimbursement is available following reliable diagnosis (currently a revision being prepared). All evidence-based treatments are available. Those with BMD T-score < 2,5, fractures, therapy resistance. Those with T-score < -2.5 or multiple fractures. Some treatments, eg PTH, only given in certain centres, and may require contacting social security for reimbursement. ( Healthy School, Campaign for Changing Nutrition Behavior (in preparation).. Organized by the Austrian Society for Bone and Mineral Research and the Institute for Osteoporosis Prevention 6
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