Provincial Performance Data for
Osteoporosis Management

The goal of the Ontario Osteoporosis Strategy is to reduce the impact of osteoporotic fractures by employing a patient-centered, multidisciplinary approach that integrates across different healthcare sectors. To assess the effectiveness of this strategy, various performance indicators have been developed to monitor osteoporosis management from a health system perspective. For the purpose of this report, we will focus on indicators that utilize available administrative data. The analysis has been conducted by the Institute for Clinical Evaluative Sciences (IC/ES) as part of their Applied Health Research Questions (AHRQ) program.

Technical Report

Evaluation Objectives:

  1. To analyze the trends in fracture rates, bone mineral density (BMD) testing, and osteoporosis treatment in Ontario from the initiation of the Osteoporosis Program (2005/06 through 2019/20).
  2. To assess and provide insights to guide the ongoing delivery and future direction of the Osteoporosis Program.

Report Overview:

This report presents updated data on fracture rates, bone mineral density (BMD) testing, and osteoporosis treatment indicators in Ontario. Additionally, it includes new indicators specifically focusing on Long-Term Care (LTC) residents.

Please note that this report supersedes previous Ontario Osteoporosis Program Reports, as the methodology and parameters used may have changed. This includes refinements to case definitions, updates to the list of osteoporosis medications with drug identification numbers (DIN), treatment adherence definitions, age categories, and follow-up time periods. The current report emphasizes trends in hip fractures, fracture rates, and management among seniors aged 80 and above, as well as in LTC settings. It also examines the variation in osteoporosis management across different Local Health Integration Networks.


Residents in LTC are at very high risk for fracture and need individualized treatment. Care
needs to be patient centred and individualized based on goals of care and life expectancy.


In 2019/20, the standardized hip fracture rates (per 10,000) for individuals aged 50 and above ranged from 24.7 in Erie St. Clair to 16.7 in Mississauga Halton. This indicates a significant variation in hip fracture rates across different Local Health Integration Networks (LHINs) and highlights the need for further investigation and analysis across various indicators.


Despite the high risk of fractures in males, they continue to be undertreated compared to females, contributing to significant health system utilization and costs associated with hip fractures.

How we are addressing the challenges

By implementing targeted interventions in three identified priority areas - fracture prevention, health professional education and outreach, and patient education and self-management - it is possible to effectively reduce the risk of hip and other osteoporotic fractures in Ontario.


Fracture Prevention

Reducing the risk of hip and other osteoporotic fractures in Ontario.


Health Professional Education and Outreach

Increasing evidence-informed practice by health care professionals.


Patient Education and Self-Management

Increasing the capacity of at-risk patients to understand and manage their fracture risk