Osteoporosis is one of the ten leading diseases with an enormous epidemiological and economic burden for societies. Research in recent years has shown that osteoporosis is not part of the "normal" aging process, but a disease with an evidence-based body of knowledge concerning diagnostics and therapy. Because the correlation of the frequency with age is high and because of the demographic dynamics in the coming years in Germany, the importance of this disease will dramatically increase. From a societal point of view, several endpoints have to be to considered, especially mortality and loss of independence after fracture. The importance of the social and economical consequences of hip fractures (excess mortality, loss of independence, institutionalization) will increase in the near future. Therefore, it is necessary to have an adequate database for different sectors of the health system (ambulatory, hospital, rehabilitation). A health system will then be able to decide on effective and efficient ways of allocating resources. The experiences of two research projects with registry data show that it is possible to demonstrate the deficits and problems of current medical care and to develop strategies for an optimization in the future.