Understanding Data and Opportunities Focused on Value: A Single-Center Experience in Headache Care

Area of Science:

• Health Services Research
• Health Economics
• Neurology

Background:

• Headache syndromes are prevalent, causing significant disability and healthcare costs.
• Current headache care delivery and associated costs within integrated health systems require detailed examination.
• Identifying opportunities for data collection and analysis is crucial for value-based headache care.

Purpose of the Study:

• To describe headache care delivery patterns and associated costs within a large health system.
• To identify system-level opportunities for data management to support value-based headache care.
• To compare healthcare costs and utilization across different headache care pathways.

Main Methods:

• A retrospective cohort study analyzed data from July 2018 to July 2021.
• Individuals were categorized into reference or headache groups based on ICD diagnoses.
• Headache care pathways were defined by the specialty primarily seen: primary care (PC), neurology (NEU), or headache subspecialist (HS).

Main Results:

• Individuals receiving care from NEU or HS incurred higher total costs of care (TCOC) than those in PC.
• Outpatient and inpatient facility costs were the largest drivers of TCOC.
• Headache subspecialists (HS) had the highest pharmacy and professional costs.

Conclusions:

• Neurologic and headache subspecialist care is associated with higher medical morbidity, utilization, and costs compared to primary care.
• Current outcome data is insufficient to determine the specific value of neurologic expertise in headache management.
• Adopting an economic evaluation framework is recommended for health systems to clarify the value of neurology in primary headache disorders.