A trans-cultural comparison of the organisation of care at headache centres world-wide.
BACKGROUND
The need to provide better outcomes for patients with headache, and to minimise the costs involved in doing so, has prompted the search for new modes of service delivery by exploring the service organisation and nursing role from various cultural, economic and global perspectives.


METHODS
This study was based on comparisons with the UK headache service up to 2007, the point at which this study was set up. This UK service was based at the National Hospital for Neurology and Neurosurgery (NHNN, UCLH Trust). Data were obtained from US headache centres in 2008 and from centres in Copenhagen, Bangkok, Sydney and Porto Alegre in 2009.


RESULTS
A comparison shows the key components of services at all centres showing the team structure and size of service. Prominent features at the centres included: team-working, regular meetings, educational input, good access and communication among team members, headache-trained neurologists, specialist nursing at most centres, and the input of psychological and physical therapists at some centres.


CONCLUSIONS
The problems of tertiary headache care are very similar throughout the world and seem to transcend ethnic, cultural and economic considerations.
Bhola
Ria
R
Headache Service, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK. rbhola@ion.ucl.ac.uk
Goadsby
Peter J
PJ
D006261:Headache; D006782:Hospitals, Special / Q000458:organization & administration*; D006801:Humans; D009462:Neurology / Q000458:organization & administration; D000078329:Workforce