The National Quality Registry for Better Management of Patients with Osteoarthritis (BOA) was initiated in response to the high cost of sick leave due to osteoarthritis and the knowledge that only a fraction of all patients who undergo osteoarthritis surgery have seen a physiotherapist at some point prior to surgery. This despite the fact that information, training and weight control form the basis of osteoarthritis treatment according to both national and international treatment guidelines.
BOA follows the National Board of Health and Welfare’s national guidelines for osteoarthritis. BOA has three clear branches:
The aim of BOA is to ensure that all patients with osteoarthritis are offered adequate information and training in osteoarthritis school, in accordance with current treatment guidelines, and that surgical interventions are only considered when non-surgical treatment has not provided satisfactory results.
The goal is to reduce health care consumption and sick leave due to osteoarthritis, and to increase quality of life and activity levels among patients with osteoarthritis of the hip or knee. Patients with osteoarthritis should receive equivalent care at their first contact with health care services, regardless of where this takes place. Patients with symptoms in their hip or knee should be able to see a physiotherapist directly, without referral from a doctor.
BOA was initiated in 2008 as a three-year collaboration between the Regions of Västra Götaland and Skåne, and the county councils of Värmland and Västerbotten, and was financed by the Social Insurance Agency and government financing to the regions. Today, osteoarthritis schools under the BOA concept are up and running in all county councils in Sweden. No referral is needed to an osteoarthritis school. Patient involvement is an important part of the BOA project, which collaborates closely with the Swedish Rheumatism Association via the Rheuma-communicator project.
The BOA registry is an intervention registry intending to include all patients with hip and/or knee osteoarthritis who have been to osteoarthritis school.
Inclusion criteria: Patients with symptoms in the hip or knee of such magnitude that they seek health care, and in which a physiotherapist determines that the symptoms come from the joints. Exclusion criteria are inflammatory joint disease, other serious diseases causing more dominant symptoms, failed femoral neck fracture, or people who do not understand Swedish and thus cannot benefit from osteoarthritis school. Interventions included in osteoarthritis school, information and training, should be offered to all persons with osteoarthritis as soon as possible in the course of the condition.
It is difficult to estimate how many people have osteoarthritis, but our figures show that 1.5 percent of the population over age 45 seek outpatient care due to hip or knee osteoarthritis every year. Other studies have shown that only about 10 percent of all those diagnosed actually seek health care, due to a belief that help is not available.
The registry included 12,000 patients as of September 2012. This figure continues to rise. In September 2012, there were 220 units reporting to the registry. This number is also increasing.
4,418 patients registered in 80 units in 2011.
We are not sure exactly how many osteoarthritis schools are operating in Sweden without reporting to the registry, but estimate that about two-thirds of the schools are included in the registry. Based on statistics from health care databases in four county councils/regions, we estimate the total osteoarthritis population seeking outpatient care at least once during a five-year period to be 308,600 individuals. If we assume that the BOA registry has the same annual capacity over five years as it did in 2011, we will have reached 22,000 patients, or 7 percent of all those seeking outpatient care with the diagnosis of hip or knee osteoarthritis.
Only self-validations to ensure data quality.
Note: Variable lists are updated on a regular basis and should therefore be seen as preliminary. For the latest version, please contact the registry.
Category: Musculoskeletal system
Certification level: 3
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