Characterizing healthcare utilization patterns in a Danish population with headache: results from the nationwide headache in Denmark (HINDER) panel

The Journal of Headache and Pain

Research

Simon Stefansen¹  Mikala Dømgaard¹  Timothy J. Steiner²  Thien Phu Do³  Messoud Ashina³ 

[1] Danish Knowledge Center On Headache Disorders, Glostrup, Denmark;Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark;Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway;Division of Brain Sciences, Imperial College London, London, UK;Department of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark;Danish Knowledge Center On Headache Disorders, Glostrup, Denmark;Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark;

关键词: Headache disorders;    Disease burden;    Healthcare utilization;    Barriers to care;    Population survey;    Denmark;   

DOI  :  10.1186/s10194-023-01553-w

 received in 2022-12-23, accepted in 2023-02-15,  发布年份 2023

来源: Springer

【 摘 要 】

IntroductionWorldwide, far from all of those who would benefit make use of headache services, largely because of clinical, social, and political barriers to access. Identifying the factors contributing to low healthcare utilization can generate evidence to guide health policy. Our purpose here is better to characterize healthcare utilization patterns in Denmark.MethodsThe Headache in Denmark (HINDER) study is a nationwide cross-sectional survey of people with headache, conducted using SurveyXact (Rambøll Group A/S, Copenhagen). Healthcare utilization was assessed in a study sample generated by population screening and recruitment. Data collection occurred over two weeks, from September 23rd until October 4th, 2021. The questions enquired into disease characteristics, management, burden, medication intake and healthcare utilization.ResultsThe number of participants included in the HINDER panel was 4,431, with 2,990 (67.5%: 2,522 [84.3%] female, 468 [15.7%] male; mean age 40.9 ± 11.6 years) completing the survey. One quarter of participants (27.7%) disagreed or strongly disagreed that they were able to manage their headache attacks. Most participants (81.7%) agreed or strongly agreed that their headache was a burden in their everyday lives. The most reported acute medications, by 87.2% of participants, were simple analgesics; of note, 8.6% reported using opioids for their headache. One quarter of participants (24.4%) had never consulted a medical doctor for their headache; one in six (16.5%: more than two thirds of the 24.4%) had never done so despite agreeing or strongly agreeing that their headache was a burden in their everyday lives. Two thirds (65.3%) of participants overall, and almost three quarters (72.4%) of those with weekly headache, had tried one or more complementary or alternative therapies outside conventional medical care.ConclusionsOur findings are indicative of inadequate delivery of headache care in a country that provides free and universal coverage for all its residents. The implications are twofold. First, it is not sufficient merely to make services available: public education and increased awareness are necessary to encourage uptake by those who would benefit. Second, educational interventions in both pre- and postgraduate settings are necessary, but a prerequisite for these is a resetting of policy priorities, properly to reflect the very high population ill-health burden of headache.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 6