Health Care : Current Reviews

Healthcare utilization for primary headache disorders in China: A population based door-to-door survey

Euro Health Care and Fitness Summit

September 01-03, 2015 Valencia, Spain

Ruozhuo Liu, Shengyuan Yu, Mianwang He, Gang Zhao, Xiaosu Yang, Xiangyang Qiao, Jiachun Feng, Yannan Fang, Xiutang Cao and Timothy J Steiner

Chinese PLA General Hospital, China

Scientific Tracks Abstracts: Health Care: Current Reviews

Abstract:

Background: In order to know the status quo of health care for primary headache disorders in China, questions about headache consultation and diagnosis were included in a nationwide population-based survey initiated by lifting the burden: The Global Campaign against headache. Methods: Throughout China, 5,041 unrelated respondents aged 18�??65 years were randomly sampled from the general population and visited unannounced at their homes. After basic socio-demographic and headache diagnostic questions, respondents with headache answered further questions about health-care utilization in the previous year. Results: Significantly higher proportions of respondents with migraine (239/452; 52.9%) or headache on �?�15 days per month (23/48; 47.9%) had consulted a physician for headache than of those with tension-type headache (TTH) (218/531; 41.1%; P < 0.05). Multivariate analysis showed associations between disability and probability of consultation in those with migraine (mild vs. minimal: AOR 3.4, 95% CI: 1.6�??7.4; moderate vs. minimal: 2.5, 1.2�??5.4; severe vs. minimal: 3.9, 1.9�??8.1) and between rural habitation and probability of consulting in those with TTH (AOR: 3.5; 95% CI: 1.9�??6.3, P<0.001). Married respondents with TTH were less likely than unmarried to have consulted (AOR: 0.26; 95% CI: 0.07�??0.93; P=0.038). About half of consultations (47.8�??56.5%) for each of the headache disorders were at clinic level in the health system. Consultations in level-3 hospitals were relatively few for migraine (5.9%) but more likely for headache on �?�15 days/month (8.7%) and, surprisingly, for TTH (13.3%). Under-diagnosis and misdiagnosis were common in consulters. More than half with migraine (52.7%) or headache on �?�15 days/month (51.2%), and almost two thirds (63.7%) with TTH, reported no previous diagnosis. Consulters with migraine were as likely (13.8%) to have been diagnosed with �??nervous headache�?� as with migraine. �??Nervous headache�?� (9.8%) and �??vascular headache�?� (7.6%) were the most likely diagnoses in those with TTH, of whom only 5.6% had previously been correctly diagnosed. These were also the most likely diagnoses (14.0% each) in consulters with headache on �?�15 days/month. Conclusions: This picture of the status quo shows limited reach of headache services in China, and high rates of under-diagnosis and misdiagnosis in those who achieve access to them. This is not a picture of an efficient or cost-effective response to major causes of public ill-health and disability.

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