A Retrospective Cohort Study of Urgent Care Visits and Revisits for Headache/Migraine

Abstract

Objective. Increasingly, patients are seeking same-day care at urgent care (UC) facilities. Little is known about the health care utilization patterns of patients who visit UC facilities for headache and migraine. We examined the frequency of headache and migraine visits and revisits at UC facilities. Methods. We conducted a retrospective cohort study of headache not otherwise specified (NOS) and migraine visits from 67 NYC UC facilities over an eight-month period. We report descriptive analyses, the frequency of headache NOS revisits, and the elapsed time to revisits. Results. There were 10,240 patients who visited UC facilities for headache NOS or migraine within the eight-month period. The majority of patients, 6,994 (68.3%), were female, and the mean age (SD) was 35.1 (15.0) years. Most (93.9%) patients (N = 9,613) lived within 60 miles of NYC; 5.5% (N = 564) had at least one revisit, and among re-visitors, there was an average (SD) of 2.2 (0.7) visits to UC facilities during the study period and an average time to revisit (SD) of 61.3 (55.2) days. Conclusions. In just eight months, there were >10,000 headache NOS and migraine visits to UC facilities in NYC, with half of revisits occurring within 90 days. Future work should examine headache management in UC facilities.

The role of urgent care centers in headache management: a quality improvement project

“…Each UC program had the capacity to offer, on average, 10 medications; ondansetron (100%, 10/10), acetaminophen PO (70%, 7/10), and ibuprofen PO (70%, 7/10) were the most common medications reported as treatment options for migraine. Regarding the highest-level recommended drugs (Level B) per the American Headache Society’s (AHS) emergency department migraine management guidelines [ 12 ], 50% (5/10) reported using subcutaneous sumatriptan, 60% (6/10) reported using intravenous (IV) metoclopramide, and 50% (5/10) reported using intravenous prochlorperazine. Across the 10 UC programs, 9 (90%, 9/10) have staff available to administer IM medications and 6 (60%, 6/10) to administer IV medications.…”

“…While two recent studies examined UCs and migraine in New York City [ 11 , 12 ], they only looked at the number of UC visits for headache and/or migraine in an 8-month period (over 10,000) [ 12 ] and migraine management in UC facilities that were part of one urban academic medical center. In the latter study, we learned that there are ways UC facilities might be optimized to treat people with migraine, i.e.…”