Department of Economics, Universitat de Barcelona, Barcelona, Spain
Department of Health Economics, BCN Health Economics & Outcomes Research SL, Barcelona, Spain.
BMJ Open. 2020 Feb 13;10(2):e034926. doi: 10.1136/bmjopen-2019-034926.
To investigate the number and characteristics of the Spanish population affected by headache disorders and the direct medical cost that these patients represent for the healthcare system.
A retrospective multicentre observational study.
Records from all patients admitted with headache in primary and secondary care centres in Spain between 2011 and 2016 that were registered in a Spanish claims database were included in the analysis. Direct medical costs were calculated using the standardised average expenses of medical procedures determined by the Spanish Ministry of Health.
Data extraction claimed primary care records from 636 722 patients and secondary care records from 30 077 patients. Women represented 63% and 65% of all patients with headache in primary and secondary care respectively, with the exception of cluster headaches, a group with 60% of male patients. No large shifts were observed over time in patients' profile; contrarily, the number of cases per 10 000 patients attended in primary care increased 2-folds between 2011 and 2016 for migraine and 1.85-folds for other headaches. Migraine was the cause for 28% of primary care consultations and 50% of secondary care admissions, and it was responsible for the largest portion of healthcare costs in 2016, a total amount of € 7 302 718. The estimated annual direct medical cost of headache disorders was € 10 716 086.
Migraine was responsible for half of the secondary care admissions linked to headache disorders. The raise detected in the number of cases registered in primary care is likely to impact the direct medical costs associated to these disorders causing an increase in the total burden they represent for the Spanish National Healthcare System.
调查受头痛障碍影响的西班牙人群数量及其特征,以及这些患者给医疗保健系统带来的直接医疗费用。
回顾性多中心观察性研究。
分析纳入了 2011 年至 2016 年间在西班牙初级和二级保健中心因头痛入院并在西班牙索赔数据库中登记的所有患者的记录。直接医疗费用是使用西班牙卫生部确定的医疗程序标准平均费用计算的。
数据提取声称从 636722 名初级保健患者和 30077 名二级保健患者的记录中提取数据。女性分别占初级和二级保健中所有头痛患者的 63%和 65%,但丛集性头痛除外,该病组 60%的患者为男性。患者特征在时间上没有明显变化;相反,初级保健中每 10000 名就诊患者的病例数在 2011 年至 2016 年间偏头痛增加了两倍,其他头痛增加了 1.85 倍。偏头痛是初级保健就诊的 28%和二级保健住院的 50%的原因,2016 年它导致了最大部分的医疗保健费用,总额为 7302718 欧元。估计头痛障碍的年度直接医疗费用为 10716086 欧元。
偏头痛是与头痛障碍相关的二级保健入院的一半原因。在初级保健中登记的病例数量增加,可能会影响与这些障碍相关的直接医疗费用,从而增加它们对西班牙国家医疗保健系统的总负担。