Περίληψη:
In countries where headache services exist at all, their focus is
usually on specialist (tertiary) care. This is clinically and
economically inappropriate: most headache disorders can effectively and
more efficiently (and at lower cost) be treated in educationally
supported primary care. At the same time, compartmentalizing divisions
between primary, secondary and tertiary care in many health-care systems
create multiple inefficiencies, confronting patients attempting to
navigate these levels (the “patient journey”) with perplexing
obstacles. High demand for headache care, estimated here in a
needs-assessment exercise, is the biggest of the challenges to reform.
It is also the principal reason why reform is necessary. The structured
headache services model presented here by experts from all world regions
on behalf of the Global Campaign against Headache is the suggested
health-care solution to headache. It develops and refines previous
proposals, responding to the challenge of high demand by basing headache
services in primary care, with two supporting arguments. First, only
primary care can deliver headache services equitably to the large
numbers of people needing it. Second, with educational supports, they
can do so effectively to most of these people. The model calls for
vertical integration between care levels (primary, secondary and
tertiary), and protection of the more advanced levels for the minority
of patients who need them. At the same time, it is amenable to
horizontal integration with other care services. It is adaptable
according to the broader national or regional health services in which
headache services should be embedded. It is, according to evidence and
argument presented, an efficient and cost-effective model, but these are
claims to be tested in formal economic analyses.
Συγγραφείς:
Steiner, Timothy J.
Jensen, Rigmor
Katsarava, Zaza
Stovner,
Lars Jacob
Uluduz, Derya
Adarmouch, Latifa
Al Jumah,
Mohammed
Al Khathaami, Ali M.
Ashina, Messoud
Braschinsky,
Mark
Broner, Susan
Eliasson, Jon H.
Gil-Gouveia, Raquel and
Gomez-Galvan, Juan B.
Gudmundsson, Larus S.
Herekar, Akbar A.
and Kawatu, Nfwama
Kissani, Najib
Kulkarni, Girish Baburao and
Lebedeva, Elena R.
Leonardi, Matilde
Linde, Mattias and
Luvsannorov, Otgonbayar
Maiga, Youssoufa
Milanov, Ivan and
Mitsikostas, Dimos D.
Musayev, Teymur
Olesen, Jes
Osipova,
Vera
Paemeleire, Koen
Peres, Mario F. P.
Quispe, Guiovanna
and Rao, Girish N.
Risal, Ajay
de la Torre, Elena Ruiz and
Saylor, Deanna
Togha, Mansoureh
Yu, Sheng-Yuan
Zebenigus,
Mehila
Zewde, Yared Zenebe
Zidverc-Trajkovic, Jasna
Tinelli,
Michela
Global Campaign Against Headache
