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Headache Drives 3 Million ED Visits Annually

Cheryl Clark, for HealthLeaders Media, May 6, 2011

Headache as a primary diagnosis prompted more than three million visits to hospital emergency rooms in 2008. More than one third of those patients went because of migraine headaches, which were much more likely to result in an admission, according to a new report from the Agency for Healthcare Research and Quality.

Of the 3,009,600 million ED visits for headaches, 81,000 resulted in an admission but 51,000, or 63.1% of those patients had a primary complaint of migraine, the agency reported.

Rates of ED visits for migraines were 4.6 times higher among females than males, and females were nearly four times as likely to be admitted because of their pain.

Also of interest is the time of year in which headache complaints, especially migraines, were serious enough to prompt a trip to the hospital, the report said. Headache visits peaked at 154,000, 157,000, and 152,000 respectively in August, September and October, and were lowest in December and February, with 69,000 and 70,000 respectively. The peaks were somewhat different or patients whose headaches were serious enough to require admission. Those headaches peaked in September and October.

Also, the rate for ED visits for a headache complaint was highest in the 18 to 44 age bracket. 

Also of note was the finding that ED visits for headache were higher in rural areas than in urban areas, and among patients who reported the lowest quartile of income compared with wealthier patients. In these categories, ED visits among patients with a headache complaint were 2.3 times higher than for patients from the wealthiest communities.

Another surprising finding was that rates of ED visits for headache complaints was lowest in the West, with 744 per 100,000 population, followed by the Northeast, with 809 visits, but highest in the Midwest and South, with 1,158 and 1,131 per 100,000 population respectively.

Headache care in 2008 cost $407.5 million, according to the report, and of that $364.8 million was for inpatient care.

The mean length of stay for a patient whose headache was serious enough to require admission was 2.7 days, with a $5,000 average cost per stay.

The statistics are derived from the federal Healthcare Cost and Utilization Project's 2008 Nationwide Inpatient Sample.


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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