Abstract text (incl. figure legends and references)

Objective: Analysis of health care indicators in headache patients at the emergency department (ER) to assess potential improvement areas.

Methods: Retrospective analysis of health care indicators of the business intelligence tool Discern Analytics 2 of Millenium (Cerner) and PowerBi (Microsoft), in the period 01/01/2019 to 02/28/2022.

Results: During the study period, 9,512 episodes of 7,427 patients (1.28 visits per patient) were recorded.

The total number of annual headache visits fell by 20% in 2020 compared to 2019. Similar drop was seen in global visits to the ER (26%). In the first month of the pandemic in our country (March 2020), there was a 46.75% decrease in visits for headaches compared to the previous month. In April 2020, the minimum number of monthly visits was reached with 59.96% reduction compared to the previous year.

Despite the decrease of total patients attended at the ER, the total number of patients admitted for headache was maintained. The 2% of all visits in ER were due to headache. Out of these, 70% were discharged with a diagnosis of nonspecific headache and 20% with a diagnosis of migraine. A brain CT scan was requested in about 40-45% of patients. The 10% were assessed by neurology. Out of these, 53% end up being admitted. 14.70% of patients who go to the emergency department for headaches also consume outpatient resources in neurology.

Conclusion: The impact of the pandemic has led to a decrease in the number of patients visited in the ER but the total number of patients admitted for headache has remained practically the same. The 2% of the emergency visits are due to headache. We should work on improving the headache coding at discharge. The number of admissions could be reduced by incorporating new alternative circuits of ambulatory care