Abstract Details

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.

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.