ACUTE TREATMENT OF PERIODIC SEVERE HEADACHE - COMPARISON OF 3 OUTPATIENT CARE FACILITIES

We compared treatment of patients with episodic, severe, migraine-vasc ular headaches in three outpatient settings associated with a major me dical center: the Charlton Outpatient Therapy Center (COTC), a dedicat ed transfusion and injection facility which provides treatment based o n physician orders written in advance of the patient's visit a walk-in Urgent Care Center (UCC); and a traditional hospital emergency trauma unit (ETU). For a 7-month period in 1995, all patient visits for acut e migraine headache to the COTC, UCC, and ETU were reviewed. Data coll ected included the treatment and charges. After the study period, a sa mple of patients was surveyed regarding their outcome and satisfaction with care at each of the three facilities. During the study period, 1 5 patients visited the COTC 446 times for the treatment of acute migra ine, 80 patients visited the UCC 233 times, and 182 patients visited t he ETU 238 times. The average charges per visit were $39.93 for the CO TC, $57.28 for the UCC, and $317.71 for the ETU. Average time spent in order to obtain care was 35 minutes in the COTC, 62 minutes in the UC C, and 105 minutes in the ETU. Intramuscular meperidine with either pr omethazine or hydroxyzine was the most commonly administered treatment in all three settings. Patients treated in the COTC reported greater satisfaction than the patients seen in the UCC or ETU. A dedicated out patient facility with extended hours of operation and the capability o f treating acute headache patients with parenteral medications based o n standing orders has provided a community of migraine sufferers with cost-effective care.