Sociodemographic differences in diagnosis and treatment of pediatric headache
Jack Stevens1, Jeffrey Harman, Ann Pakalnis
1Department of Pediatrics, Ohio State University, Columbus, Ohio 43205, USA. Jack.Stevens@nationwidechildrens.org
Insights
Pediatric headache diagnoses and treatments show sociodemographic disparities. Children with private insurance and minority children were less likely to receive a neurologist diagnosis, and evidence-based medication use was low for all headache patients.
Area of Science:
- Pediatric healthcare
- Neurology
- Health services research
Background:
- Headaches are a common complaint in pediatric healthcare visits.
- Understanding sociodemographic disparities in diagnosis and treatment is crucial for equitable care.
- Previous research has highlighted access and quality variations in pediatric specialty care.
Purpose of the Study:
- To investigate sociodemographic differences in pediatric headache diagnoses.
- To examine disparities in neurologist diagnosis and evidence-based medication prescription for pediatric headaches.
- To identify potential inequities in headache care for children across the U.S.
Main Methods:
- Utilized two nationally representative databases: National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS).
- Analyzed pediatric healthcare visits involving a headache diagnosis.
- Compared diagnosis rates by insurance type and race/ethnicity, and assessed prescription of evidence-based medications.
Main Results:
- Headache diagnoses were less frequent during visits for privately insured children compared to those with Medicaid.
- While diagnosis rates were similar for Caucasian, African American, and other racial/ethnic groups, minority children were less likely to see a neurologist.
- Only 37% of pediatric headache visits resulted in an evidence-based medication prescription.
Conclusions:
- Sociodemographic factors, including insurance status and race/ethnicity, are associated with disparities in pediatric headache care.
- There are significant gaps in the utilization of neurologists and evidence-based treatments for pediatric headaches.
- Further research and interventions are needed to address inequities in pediatric headache management.
Abstract:
The authors investigated the sociodemographic differences in receiving a headache diagnosis for pediatric health care visits using 2 nationally representative databases--the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. For those visits involving a headache diagnosis, the authors explored 2 possible disparities in care--being diagnosed by a neurologist and being prescribed an evidence-based medication. A headache diagnosis was less common during visits for private insurance patients versus Medicaid patients. In addition, while a headache diagnosis was equally likely for visits by Caucasian American children versus African American children and children of other races, visits for the latter 2 groups were less likely to involve a headache diagnosis from a neurologist. Finally, only 37% of the headache visits involved a prescription of an evidence-based medication. The authors conclude that some sociodemographic disparities exist in pediatric headache care across the United States.
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