title: Osteoporosis in Spain: map of resources for diagnosing.
abstract: The World Health Organization has warned that osteoporosis (OP) is one of the leading health problems in the Western world because of its high prevalence and social and health implications. Densitometry using dual-energy X-ray absorptiometry (DXA) is the procedure of choice to diagnose OP before fragility fractures occur. The purpose of this study is to quantify and establish the distribution of resources for diagnosis and management of OP in Spain. A secondary objective is to ascertain the available means and the unmet needs of physicians involved in equipment use. The existence and location of central DXA machines both in and out of hospitals was investigated. Their use and performance, as well as current availability and unmet needs by physicians involved in their use were analyzed. Peripheral DXA machines were not included in the census because they can be multicenter and itinerants. Information was obtained from 232 central DXA machines throughout the Spanish territory, of which 43 were for public use, 42 in officially approved hospitals, and 147 in private institutions. The national population coverage was 5.4/million inhabitants. Most of the publicly owned DXAs are in big hospitals (>500 beds) and mainly attend requests from the hospitals themselves. Use of such equipment is mainly clinical in 87%, 88%, and 96% of public, officially approved, and private institutions, respectively. The daily number of densitometries is higher in the public health system compared with private institutions, because equipment is used on average 7h daily, 5d/wk. If only public DXAs are considered, there is an inadequate coverage with territorial differences. The needs expressed by the physicians involved in OP management are not adequately met. Resources should be increased or their efficiency should be modified.
authors.affiliation: Department of Internal Medicine, Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Manuel Díaz
authors.initials: MD
authors.lastname: Curiel
authors.forename: Cristina
authors.initials: C
authors.lastname: Carbonell
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Quesada Lopez
mesh_terms: D015502:Absorptiometry, Photon / Q000295:instrumentation*; D000328:Adult; D000368:Aged; D005260:Female; D006295:Health Resources; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015995:Prevalence; D013030:Spain / Q000453:epidemiology