Country Good Practice Presentation And Key Policy Recommendations: Sweden

Country good practice presentation and key policy recommendations: Sweden Ingemar Petersson, MD, PhD, Ass.professor Lund University Hospital Lund Sweden

Sweden – a country of registers • Medical and Health Care Quality Registers – National (since 1975) – Regional – Local

• National Population Registers – In patient care – Causes of death – Cancer register etc.

• Regional Health Care Databases • National Swedish Social Insurance Agency register – Sick leave – Disability Pensions

Country good practice: Sweden – a country of collaboration • Health Care for patients with Musculoskeletal disorders – – – –

General Practitioners/Family Doctors Orthopaedic surgeons Rheumatologists Rehabilitation Medicine

• National Authorities – The Swedish Social Insurance Agency – The Swedish Public Employment Service

• Patients´Organisations – The Swedish Rheumatism Association – Others

Linking Register data in the MORSEprojektet National and Regional Registers SCB, EpC (Pharmacotherapy, Profession etc)

Linking personal ID code

Försäkringskass Region an Skåne Health National Insurance Care Database Agency: data on sick leave and Anonymous datadisability pensions

Data Output

Prevalence figures for RA, Knee OA, Hip OA (health care seeking) Skåne, South Sweden, December 31 2006

Ag e Ingemar F Petersson, www.morse.nu Data from the MORSE-projet, Martin Englund,

•Cases had an increased risk for sick leave compared with controls with a relative risk of 1.8; 95% CI 1.5, 2.1 •Cases had more days with sick leave than controls (median number of more days per year 30; 95% CI 2, 72).

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SEK 200000

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Total cost of illness for AS vs Controls (SEK)

Controls

Patients sumtot2005

sumtot2006

Sick Leave in patients with Ankylosing Spondylitis (AS) treated with TNF blockers 2004-2007 in Region Skåne as compared to controls

-Preliminary data from the MORSE project and the SSATG register (LarsErik Kristensen, Pierre Geborek, Tor Olofsson, Martin Englund, Thor Lithman, Ingemar Petersson et al) www.morse.nu

Rheumatoid Arthritis Treatment in Sweden • National guidelines • Biologics for 10-20 % of patients • Register follow-up – National (ARTIS) – Regional (SSATG and MORSE in Skåne). Patients on TNFblockers: • Reduced in-patient care with 50% 2003-2007 • Reduced need for hip arthroplasty with 30% 20032007 • Reduced sick leave frequency with 27% (and disability pension) – Better effect for patients with disease duration < 32 months

• National clinical trials •

Addition of infl iximab compared with addition of sulfasalazine and

hydroxychloroquine to methotrexate in patients with early

Osteoarthritis in Sweden • Osteoarthritis is • Just • in

•TIME Osteoarthritis is a trendy and exciting disorder... (Professor Paul A Dieppe, Bristol UK)

Osteoarthritis in Sweden • Welcome to JRU at the • Department of Orthopaedics • Faculty of Medicine, Göteborg University. • Swedish Hip Arthroplasty Register • Annual Report 2007

Better OsteoArthritis care –the BOA Initiative

www.boaregistret.se

Country good practice: Back Pain • National guidelines (2010) • National Rehabilitation Initiative – The REGASSA project (www.regassa.se)

• Regional Initiatives – Back- Upp (Pilot project) – Region Skåne – Standardized care and rehabilitation in Primary Health Care – Collaboration with • The Swedish Social Insurance Agency • The Swedish Public Employment Service

Sweden in Europe - EUMUSC.NET • •

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The EUMUSC:NET- project intends to: Encourage cooperation between Member States and promote a comprehensive EU strategy with the aim of minimising the impact of musculoskeletal conditions Improve information and knowledge on musculoskeletal conditions Promote health, increase awareness on the musculoskeletal conditions and reduce the impact of musculoskeletal conditions Raise quality of care and harmonise standards of care of rheumatic diseases and other musculoskeletal conditions across the Member States by further developing and operationalising a relevant health information system. Identify and help overcome the barriers to the effective prevention and management of these conditions in the Member States. Reduce environmental, social, gender and geographical

A better life for patients with musculoskeletal disorders…

Life. Marc Chagall, Fondation Maeght, Nice