OBJECTIVES: The national health insurance database covers 97% of the population in Hungary. The aim of our study was to assess the osteoporosis related health care utilisation and disease management in Hungary, focussing on hip fractures and on the activity of the qualyfied Osteoporosis Centre (OPC) network. METHODS: A systematic search was performed in the database between 1999-2003. Patients of age 50-100 with fractures and/or osteoporosis were identified. Reports on visits to OPCs, osteodensitometries were analysed by age and gender. RESULTS: Hip fractures increased consistently (women: 8570-9180, men 2200-3480) leading to mean 556,800/40,450 acute, and 3,652/1,129 chronic bed days/year, respectively. A total of 67,600 women (115,860 cases) and 5,980 men (9,010 cases) visited an OPC in 1999; while 151,340 (261,550) and 13,300 (19,770) in 2003. A total 345,060 women and 36,130 men had osteoporosis diagnosis in an OPC during the 5 years, 49% and 45% of them was 50-65 years age. A total 94-98% of the patients had osteodensitometry in the year of the diagnosis. 47.1%, 37.9% and 38.1% of women with hip, forearm or shoulder fracture did not have osteoprosis diagnosis during the 5 years (men: 89.1%, 88.6%, 88.8%). Osteodensitometry was performed in 5%, 13% and 11.6% of women with hip, forearm or shoulder fracture in 1999, slightly higher rates occurred in 2002 (6.9%, 18.8% and 16%); lower proportions were observed in males (2.2-2.9%) and 3-5% of the patients had osteoporosis diagnosis. CONCLUSION: Hip fracture has a significant burden on the health care system in Hungary. Osteoporosis related health care utilisation increased consistently in the time period observed. However, the rate of patients screened for osteoporosis before fracture was rather low and patient ways for osteporosis management after fracture were not guaranteed. Our study provide helpful data for further target population identification and health care improvement projects.