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 MORSE-
projektet National and
Regional Registers
SCB, EpC
(Pharmacotherapy,
Profession etc)

Linking Försäkringskass
Region personal an
Skåne Health ID code 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).
 Total cost of illness for AS vs Controls (SEK)
400000
300000
200000
SEK
100000
0

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 (Lars-
Erik 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 TNF-
blockers:
• Reduced in-patient care with 50% 2003-2007
• Reduced need for hip arthroplasty with 30% 2003-
2007
• 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
• 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