Utilization of Health Care Resources and Sick Leave in a Large Cohort of Migraine Patients: A Real-world Data Analysis
Alla Shifrin1, Shlomo Vinker2, Danna-Li Davidovici3, Matanya Tirosh3, Itay Forschner4, Erel Domany4, Ariel Israel2
1Rambam Medical Center, 2Leumit Health Services, 3Pfizer Pharmaceuticals Israel LTD, 4Rambam Healthcare Campus
Objective:

To investigate the extent of healthcare resource utilization (HCRU) and sick leave among migraine patients and compare these rates between migraine and non-migraine populations among adult members of Leumit Healthcare Services (LHS), a national healthcare provider.

Background:

Migraine is a common condition among individuals aged 35-49 years, and its associated disability significantly impacts the most productive years of one's life. However, there is inconclusive data regarding the extent of HCRU among migraine patients.

 

Design/Methods:

We conducted a retrospective descriptive study using electronic health records from LHS to assess the extent of HCRU and sick leave among adult LHS members between 2017 and 2022. Migraine patients were compared to control patients of the same age, gender, ethnic group, regional district, and socioeconomic status (SES) in a 1:1 ratio.

 

Results:

Compared to matched control individuals, migraine patients had a significantly higher number of annual general practitioner (GP) visits (SMD=0.361, <0.001), higher rates of visits to neurologists (OR=3.60; CI 3.38 to 3.84), pain specialists (OR=2.42; CI 2.13 to 2.77), and other physicians (excluding GP/neurologists/pain specialists), both within LHS and external healthcare providers. Migraine patients also had higher rates of nurse visits (OR=1.42; CI 1.37 to 1.48), emergency department visits (OR=1.44; CI 1.38 to 1.51), hospitalizations (OR=1.22; CI 1.13 to 1.31), and day hospitalizations (OR=1.28; CI 1.15 to 1.43). Additionally, the rate of sick days taken was significantly higher among migraine patients (OR=1.43; CI 1.38 to 1.49).

Conclusions:

Individuals with migraine utilize healthcare resources to a greater extent, exhibiting higher rates of visits to general practitioners, neurologists, pain physicians, and other physicians in general. They also have elevated rates of emergency department visits and hospitalizations. Moreover, migraine patients more frequently request 'sick certificates' from their treating physicians, which not only reflects increased healthcare costs but also additional burden on the economy.

10.1212/WNL.0000000000206451