Use of outpatient medical care by headache patients in Germany: a population-based cross-sectional study
Tóm tắt
Headache sufferers in need of professional health care often do not utilize the care available, and factors influencing headache-specific physician consultation are not yet understood. Objectives of this study are (1) to assess self-reported headache-specific physician consultations and (2) to identify headache-related and sociodemographic predictors. Data of a random sample of the general population in Germany aged ≥14 years were analyzed (N = 2461). A multivariate binary logistic regression was conducted to identify a parsimonious model to predict physician consultation. 50.7% of the participants with headache reported at least one headache-specific physician consultation during lifetime. Of these, 53.6% had seen one, 26.1% two, and 20.3% more than two physicians because of their headaches. The odds of physician consultation increased with the number of headache days per month (HDM) [(reference HDM < 1) HDM 1–3 (OR = 2.29), HDM 4–14 (OR = 2.41), and HDM ≥15 (OR = 4.83)] and increasing Headache Impact Test score (HIT-6) [(reference “no or little impact”) moderate impact (OR = 1.74), substantial impact (OR = 3.01), and severe impact (OR = 5.08)]. Middle-aged participants were more likely to have consulted than younger and older ones [(reference 14–34 years) 35–54 years (OR = 1.90), 55–74 years (OR = 1.96), ≥75 years (OR = 1.02)]. The odds of physician consultation among self-employed subjects were lower than among employed manual workers (OR = 0.48). The living environment (rural versus urban) did not have an influence on the consultation frequency. The results indicate that apart from burden-related factors (headache frequency; headache impact), health care utilization patterns are also influenced by patients’ occupational status and age. Further research is needed to analyze whether the lower consultation rate means that the self-employed have a higher risk of chronification or that they have more effective self-management strategies regarding headache.
Tài liệu tham khảo
Bigal ME, Krymchantowski AV, Lipton RB (2009) Barriers to satisfactory migraine outcomes. What have we learned, where do we stand? Headache 49(7):1028–1041
Steiner T, Antonaci F, Jensen R, Lainez M, Lanteri-Minet M, Valade D (2011) Recommendations for headache service organisation and delivery in Europe. J Headache Pain 12(4):419–426
Babitsch B, Gohl D, von Lengerke T (2012) Re-revisiting Andersen’s behavioral model of health services use: a systematic review of studies from 1998–2011. GMS Psycho-Social-Medicine 9:1-15.
Andersen R, Newman JF (1973) Societal and individual determinants of medical care utilization in the United States. Milbank Memorial Fund Q Health Soc. 51(1):95–124
Andersen RM (1995) Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav 36(1):1–10
Andersen RM, Davidson PL, Baumeister SE (2007) Improving access to care in America. Changing the US health care system: key issues in health services policy and management 3a edición. Jossey-Bass, San Francisco, pp 3–31
Lantéri-Minet M, Massiou H, Nachit-Ouinekh F, Lucas C, Pradalier A, Radat F et al (2007) The GRIM2005 study of migraine consultation in France I. determinants of consultation for migraine headache in France. Cephalalgia. 27(12):1386–1397
Lipton R, Serrano D, Holland S, Fanning K, Reed M, Buse D (2012) Barriers to the diagnosis and treatment of migraine: effects of sex, income, and headache features. Headache 53(1):81–92
Lucas C, Chaffaut C, Artaz M, Lanteri-Minet M (2005) FRAMIG 2000: medical and therapeutic management of migraine in France. Cephalalgia. 25(4):267–279
Wang SJ, Fuh J, Young Y, Lu S, Shia B (2001) Frequency and predictors of physician consultations for headache. Cephalalgia. 21(1):25–30
Lavados P, Tenhamm E (2001) Consulting behaviour in migraine and tension-type headache sufferers: a population survey in Santiago, Chile. Cephalalgia 21(7):733–737
Albers L, Straube A, Landgraf MN, Filippopulos F, Heinen F, von Kries R (2015) Migraine and tension type headache in adolescents at grammar school in Germany–burden of disease and health care utilization. J Headache Pain 16(1):52
Linet MS, Celentano DD, Stewart WF (1991) Headache characteristics associated with physician consultation: a population-based survey. Am J Prev Med 7(1):40–46
Lipton R, Stewart W, Simon D (1998) Medical consultation for migraine: results from the American migraine study. Headache 38(2):87–96
Lipton RB, Stewart WF, Liberman JN (2002) Self-awareness of migraine: interpreting the labels that headache sufferers apply to their headaches. Neurology. 58(9 suppl 6):S21–SS6
Lipton R, Scher A, Kolodner K, Liberman J, Steiner T, Stewart W (2002) Migraine in the United States epidemiology and patterns of health care use. Neurology. 58(6):885–894
Liu R, Yu S, He M, Zhao G, Yang X, Qiao X et al (2013) Health-care utilization for primary headache disorders in China: a population-based door-to-door survey. J Headache Pain 14(1):47
Thomas E, Boardman H, Ogden H, Millson D, Croft P (2004) Advice and care for headaches: who seeks it, who gives it? Cephalalgia. 24(9):740–752
Silberstein SD, Lee L, Gandhi K, Fitzgerald T, Bell J, Cohen JM (2018) Health care resource utilization and migraine disability along the migraine continuum among patients treated for migraine. Headache. 58(10):1579–1592
Hunt K, Adamson J, Hewitt C, Nazareth I (2011) Do women consult more than men? A review of gender and consultation for back pain and headache. J Health Serv Res Policy 16(2):108–117
Diamond S, Bigal ME, Silberstein S, Loder E, Reed M, Lipton RB (2007) Patterns of diagnosis and acute and preventive treatment for migraine in the United States: results from the American Migraine Prevalence and Prevention study: CME. Headache 47(3):355–363
Lipton R, Bigal M, Diamond M, Freitag F, Reed M, Stewart W et al (2007) Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. 68(5):343–349
Lipton R, Scher A, Steiner T, Bigal M, Kolodner K, Liberman J et al (2003) Patterns of health care utilization for migraine in England and in the United States. Neurology. 60(3):441–448
Lipton RB, Diamond S, Reed M, Diamond ML, Stewart WF (2001) Migraine diagnosis and treatment: results from the American migraine study II. Headache 41(7):638–645
Rokick LA, Holroy KA (1994) Factors influencing treatment-seeking behavior in problem headache sufferers. Headache 34(7):429–434
Celentano DD, Linet MS, Stewart WF (1990) Gender differences in the experience of headache. Soc Sci Med 30(12):1289–1295
Latinovic R, Gulliford M, Ridsdale L (2006) Headache and migraine in primary care: consultation, prescription, and referral rates in a large population. J Neurol Neurosurg Psychiatry 77(3):385–387
Laughey W, Holmes W, MacGregor A, Sawyer J (1999) Editors. Headache consultation and referral patterns in one UK general practice. Cephalalgia 19(4):328–329
Lantéri-Minet M, Valade D, Geraud G, Chautard M, Lucas C (2005) Migraine and probable migraine–results of FRAMIG 3, a French nationwide survey carried out according to the 2004 IHS classification. Cephalalgia. 25(12):1146–1158
Lucas C, Géraud G, Valade D, Chautard MH, Lantéri-Minet M (2006) Recognition and therapeutic management of migraine in 2004, in France: results of FRAMIG 3, a French nationwide population-based survey. Headache 46(5):715–725
Radtke A, Neuhauser H (2012) Low rate of self-awareness and medical recognition of migraine in Germany. Cephalalgia. 32(14):1023–1030
Müller B, Dresler T, Gaul C, Glass Ä, Jürgens TP, Kropp P et al (2019) More attacks and analgesic use in old age: self-reported headache across the lifespan in a German sample. Front Neurol 10:1000
Kosinski M, Bayliss M, Bjorner J, Ware J, Garber W, Batenhorst A et al (2003) A six-item short-form survey for measuring headache impact: the HIT-6™. Qual Life Res 12(8):963–974
Erikson R, Goldthorpe JH (1992) The constant flux: a study of class mobility in industrial societies: Oxford University press, USA
Goldthorpe JH, McKnight A (2006) The economic basis of social class. Mobility Inequality:109–136
Löffler U, Behrens K, von der Heyde C (2014) Die Historie der ADM-Stichproben. In: ADM (ed) Stichproben-Verfahren in der Umfrageforschung Eine Darstellung für die Praxis 2. Auflage ed. Springer VS, Wiesbaden, pp 67–84
Holm S (1979) A simple sequentially rejective multiple test procedure. Scand J Stat:65–70
Schochet PZ (2008) Technical Methods Report: Guidelines for Multiple Testing in Impact Evaluations. NCEE 2008–4018. National Center for Education Evaluation and Regional Assistance
Agresti A, Kateri M (2011) Categorical data analysis: springer
Rasmussen BK, Jensen R, Olesen J (1992) Impact of headache on sickness absence and utilisation of medical services: a Danish population study. J Epidemiol Community Health 46(4):443–446
Edmeads J, Findlay H, Tugwell P, Pryse-Phillips W, Nelson R, Murray T (1993) Impact of migraine and tension-type headache on life-style, consulting behaviour, and medication use: a Canadian population survey. Can J Neurol Sci 20(2):131–137
Lampl C, Buzath A, Baumhackl U, Klingler D (2003) One-year prevalence of migraine in Austria: a nation-wide survey. Cephalalgia. 23(4):280–286
Radtke A, Neuhauser H (2009) Prevalence and burden of headache and migraine in Germany. Headache 49(1):79–89
Malone CD, Bhowmick A, Wachholtz AB (2015) Migraine: treatments, comorbidities, and quality of life, in the USA. J Pain Res 8:537
Lipton RB (2011) Chronic migraine, classification, differential diagnosis, and epidemiology. Headache 51:77–83
Martins KM, Bordini CA, Bigal ME, Speciali JG (2006) Migraine in the elderly: a comparison with migraine in young adults. Headache 46(2):312–316
Stephan U, Roesler U (2010) Health of entrepreneurs versus employees in a national representative sample. J Occup Organ Psychol 83(3):717–738
Hagqvist E, Toivanen S, Bernhard-Oettel C (2018) Balancing work and life when self-employed: the role of business characteristics, time demands, and gender contexts. Soc Sci 7(8):139
Landstad BJ, Hedlund M, Vinberg S (2017) How managers of small-scale enterprises can create a health promoting corporate culture. Int J Workplace Health Manag 10(3):228–248
Hagqvist E, Toivanen S, Vinberg S. The gender time gap: Time use among self-employed women and men compared to paid employees in Sweden. Time Soc. 2016:0961463X16683969
Bundesamt AS (2017). Statistisches Jahrbuch, 2017: Deutschland und Internationales: Wiesbaden, Statistisches Bundesamt
Bundesamt A. S. (2016) Sozialleistungen. Angaben zur Krankenversicherung (Ergebnisse des Mikrozensus): Wiesbaden, Statistisches Bundesamt
Goldthorpe J (1998) Rational action theory for sociology. Br J Sociol 49:167–192
Doretti A, Shestaritc I, Ungaro D, Lee J-I, Lymperopoulos L, Kokoti L, et al. Headaches in the emergency department–a survey of patients’ characteristics, facts and needs. The journal of headache and pain. 2019;20(1):100
Vo P, Fang J, Bilitou A, Laflamme AK, Gupta S. Patients’ perspective on the burden of migraine in Europe: a cross-sectional analysis of survey data in France, Germany, Italy, Spain, and the United Kingdom. The journal of headache and pain. 2018;19(1):82