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Abstract Details

Services for Headache Disorder(s) among Men and Women Veterans across the Veterans Health Administration – a 10-year Cohort Study
Headache Posters (7:00 AM-5:00 PM)

VHA serves more than 6 million Veterans annually (86% men). Little is known about headache in Veterans. Provider type can influence headache diagnosis and treatment. Existing research suggests women are more likely to present for headache in specialty-care settings than men.

To evaluate where veterans with headache receive care within the Veterans Health Administration (VHA) system.  

The Headache Centers of Excellence Headache Cohort includes health systems data for the 1,524,960 Veterans with >1 ICD9/ICD10 headache diagnosis coded for a visit in VHA from fiscal year 2008 - 2019. T-tests with Satterthwaite methods for non-equal variances were used to evaluate mean differences in number of encounters and provider types. Logistic regression evaluated gender differences in provider types.

Men comprised 82.8% of Veterans presenting with headache. Women had more headache encounters per fiscal year (M = 2.5, SD = 2.9) than men (M = 2.2, SD = 2.4), p< .001, and saw a greater number of provider types (M = 1.5, SD = 0.9) than men (M = 1.3, SD = 0.8), p < .001. Approximately three-quarters (74.0%) of Veterans had headache coded in Primary Care. Proportionately, more women than men presented in all departments except Primary Care (women vs. men: 69.5% vs. 71.9%, p < .001) and Physical Medicine & Rehabilitation (women vs. men: 6.7% vs. 9.9%, p < .001). A greater proportion of women presented to Neurology (27.4%) than men (20.8%), p < .001. Fewer than a quarter of Veterans (23.3%) presented to the emergency department for headache, with a greater proportion of women (25.5%) than men (22.9%), p < .001.

Veterans presenting for headache care at the VHA most commonly do so in Primary Care. Of the specialty care settings, a greater proportion of women receive care in Neurology, whereas a greater proportion of men receive care in Physical Medicine & Rehab. 
Elizabeth Seng, PhD (Yeshiva University, Albert Einstein College of Medicine)
Dr. Seng has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for GlaxoSmithKline. Dr. Seng has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Click Therapeutics. The institution of Dr. Seng has received research support from NINDS.
Brenda Fenton Brenda Fenton has nothing to disclose.
Kaicheng Wang (Yale School of Public Health) Kaicheng Wang has nothing to disclose.
Melissa Skanderson (VA) Melissa Skanderson has nothing to disclose.
Jason J. Sico, MD, FAAN Dr. Sico has nothing to disclose.