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The following is a summary of “Understanding Data and Opportunities Focused on Value: A Single-Center Experience in Headache Care,” published in the October 2024 issue of Neurology by Wilson et al.
Headache syndromes are prevalent, disabling, and costly to individuals and health systems.
Researchers conducted a retrospective study to evaluate headache care delivery and costs.
They analyzed data from an extensive integrated health system (July 2018 and July 2021). Participants were divided into a reference (REF) or headache group based on headache-related ICD diagnoses. For those in the headache group, the primary exposure variable was the headache specialty consulted most frequently after the initial diagnosis, primary care (PC), neurology (NEU), or headache subspecialist (HS). The study focused on several outcomes, including all-cause costs per member per month, per episode costs, all-cause utilization, and headache utilization. Key variables included age, sex, insurance contract, and the Adjusted Clinical Groups (ACG) concurrent risk score. Calculated univariate statistics for clinical indicators and outcomes for each group, reporting outcome statistics adjusted for the ACG risk score.
The results showed that 84% of individuals in the headache group received care from PC, 14% from NEU, and 2% from HS. Total cost of care (TCOC) was highest in NEU and HS, with outpatient facility costs as the largest driver, followed by inpatient facility costs. After risk adjustment, all-cause inpatient admissions and headache-related ED visits were similar, with increased outpatient visits to PC and NEU across exposure groups.
They concluded that individuals observed by neurologists or HS had higher medical morbidity, utilization, and costs compared to those receiving care from PC providers.
Source: neurology.org/doi/10.1212/CPJ.0000000000200347
