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Healthcare utilization among adults with serious headache and comorbid depression in the US population

Horoko Takaki, Ichiro Ieiri, Hidetoshi Shibuta, Daisuke Onozuka, Akihito Hagihara


Rationale, aims and objectives: A relationship between physicians and patients with serious headache has an influence on healthcare utilization. However, there is insufficient evidence related to healthcare utilization among headache patients with comorbid depression. The present study aimed to compare and identify barriers to healthcare utilization among US adults with serious headache and comorbid depression.

Methods: We used data from the 2012 National Health Interview Survey, comprising a sample of 34,525 adults. Multivariate logistic regression models were used and adjusted by sociodemographics and several chronic conditions.

Results: Adults with serious headache and comorbid depression had significantly more healthcare visits, hospital emergency visits and trouble finding a healthcare provider than adults with neither condition. Regarding adults with a usual place of care, adults with both conditions had significantly higher odds of changing their usual place of care than adults with neither condition. Further, barriers to healthcare utilization in adults with both conditions, without a usual place of care, were significantly associated with the following aspects: “Doesn’t like /trust /believe in doctors” and “Too expensive /no insurance /cost.”

Conclusions: The results of this study indicate that headache patients with comorbid depression had more difficulties with physicians compared to adults with neither condition. The barriers to healthcare utilization were not convenience, but distrust of doctors or the cost of healthcare. Developments of the relationship between physicians and headache patients with comorbid depression could enable the patients to have regular healthcare visits, improve their health outcomes and reduce the burden of suffering, important indices as part of the person-centered healthcare approach.


Anxiety, clinical communication, clinical outcomes, comorbidity, depression, doctor shopping, economic burden, headache, healthcare utilization, multiple treatment providers, National Health Interview Survey, pain assessment, person-centered healthcare, p

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