To determine whether socioeconomic data is associated with the utilization of unplanned healthcare resources utilization (HRU) in patients with migraine headaches.

Migraine is a common, chronic neurologic condition with known, but sparsely investigated, disparities in care.  The Area Deprivation Index (ADI) ranks neighborhoods by socioeconomic disparity using 17 census variables. ADI may provide critical insights regarding disparities in care for people living with migraine headaches and associated HRU.

We performed a retrospective cohort analysis of patients with a diagnosis of migraine seen at 18 outpatient neurology clinics within an academic health system between 2018 and 2023.  We used patients' zip codes to determine ADI, and then split the sample into two groups based on their ADI, with one group representing high ADI (>85%) and the second representing lower ADI (<84%). The two groups were compared across four domains (Mortality all causes, Hospitalization all causes, ED treatment and release all causes, and Urgent care all causes) at 7, 30, and 90-day from index clinic visit.

The cohort consisted of 20785 unique patients, 83.7% female, median age 45.1 years, and median ADI 67.1. The high ADI group (>85%) included 3090 patients. Patients with high ADI had significantly increased odds of all cause hospitalization within 90 days [OR 1.328 (1.091, 1.616)], as well as ED visits without admission within 7 days [1.514 (1.088, 2.107)], 30 days [1.578 (1.312,1.898)], and 90 days [1.681 (1.4583, 1.905)] respectively.

Socioeconomic demographic data may predict unplanned HRU in patients with migraine. Our findings demonstrate a novel approach for assessing disparities in outcomes associated with migraine headaches. These results will assist in the development of targeted tools for timely interventions. Moreover, these results suggest that ADI may be used to identify patients who would benefit from additional support to improve migraine care and decrease unplanned HRU.