This is the first hard data report which I've seen on a situation which we have assumed to be true.
==========
Lack of Access to Specialty Care, Insufficient Research Funds Plague Headache


July 10, 2008 (Boston, Massachusetts) — Two new studies suggest that US patients with headache lack access to specialty care and that the field is suffering from a serious shortage of research funding.

In the first study, investigators developed a national and state-by-state report card of access to headache care in the United States and found that even those states ranked as having the best access were frequently lacking.

"By any standard, specialized care is widely unavailable across the United States, and even the highest ranking states are not doing very well," said principal investigator Elizabeth Loder, MD, from the department of neurology at Brigham & Women's Hospital, in Boston, Massachusetts.

In the second study, investigators at Washington University School of Medicine, in St. Louis, Missouri, examined the headache research funded by the National Institutes of Health (NIH) over the past 20 years.

Among other findings, the study revealed the total NIH annual budget for headache research is approximately $13 million. However, relative to the burden of disease and compared with other chronic conditions, including epilepsy, asthma, and diabetes, the researchers concluded NIH-funded headache research falls far short of the mark.

"We were able to identify only 111 research projects over a 20-year period funded by the NIH. If we compare the funding of headache to other chronic diseases, accounting for multiple different burdens of illness, it suggests that NIH funding of headache research should be greater than $100 million annually," said study investigator Todd Schwedt, MD.

Both studies were presented here at the recently held 50th Annual Meeting of the American Headache Society (AHS).

Expert Advisory Group

To identify and highlight deficiencies in access to specialty headache services, Dr. Loder brought together an advisory group of headache experts and consumers to develop indicator measures and benchmarks of access to care.

"We chose availability of care as a measure of quality, because we reasoned that it doesn't really matter how good care is if people can't access it," said Dr. Loder.

The advisory group looked at 3 major indicators of access to care. These were:

Supply — Measured by the number of AHS member headache specialists per million residents and the number of specialty headache inpatient programs per state.
Availability — Measured by the longest distance a resident would have to travel to see an in-state headache specialist and average waiting times for evaluation with an in-state headache specialist on a nonurgent basis.
Affordability — Measured by the number of triptan tablets per month covered by a state Medicaid program and the percentage of state residents with health insurance.
Using the best available data, a numerical score was calculated for each state and measured against the panel's benchmarks. A score of 100 was considered satisfactory; between 75 and 99 was rated as satisfactory minus; between 55 and 74 was unsatisfactory; and a score of less than 55 was a failing grade.

For supply, the top-ranking state was New Hampshire. Wyoming and Idaho ranked poorest in this area, with no AHS member headache specialists in the state. Multidisciplinary, long-stay dedicated inpatient headache treatment programs were available only in Illinois and Michigan.

==============Balance of article deleted=========