Value of organized headache care

This paper starts by outlining the present situation of traditional headach e therapy on the basis of up-to-date empirical data on headache epidemiolog y, the habits of the persons affected, and the economic consequences for em ployers, health insurance funds and society in general. It also describes f or the first time the direct costs of in-patient headache therapy in a trad itional treatment context without specially organized therapy on the basis of actual invoicing between hospitals and health insurance funds. New forms of specifically organized headache prevention and headache therapy in Germ any are explained with the aid of two examples. Finally, it provides an ove rview of the clinical and economic efficiency of facilities with new forms of organisation for specialized pain therapy. Their effectiveness can be se en both in a marked reduction in individual suffering and in low-cost provi sion of services for the institutions bearing the costs and for society. Th is effectiveness can be registered not only with the aid of subjective para meters by interviewing the patients, but also by means of objective target parameters such as resumption of work, reduction in intake of medication, c ost reductions due to reduced demands on the healthcare system and avoidanc e of premature pensioning. By contrast, patients who do not receive special ly organized treatment, despite the bet that they need it, display either c onstant suffering or even a worsening of their symptoms and an increase in the need for financial compensation. In view of this situation, specialized headache and pain therapy with a special focus on catering for the needs o f chronic headache suffering is called for, both on economic and on ethical grounds. Eur J Neurol 6 (suppl 2):S43-S55 (C) 1999 Lippincott Williams & W ilkins.