Not Now Ive Got A Headache

October 28, 2002
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GRAND RAPIDS — A recent University of Michigan study conducted among Bank One employees nationally suggests that during 2000 the institution probably lost more than $20 million because of migraine headaches.

But Mark Gostine, M.D., the founder of a West Michigan pain specialization practice, says it doesn’t necessarily have to be that way.

The study indicated that the bank’s loss resulted not only from the direct cost in medical and pharmacy benefit claims but also through the indirect costs arising from diminished productivity, thanks to the suffering that employees endure when having the headaches.

Gostine, the founder and senior practitioner of Michigan Pain Consultants, says migraine often is manageable by both its sufferers and the businesses that employ those sufferers.

Lost time absenteeism is not the issue with migraine. The U-M study, in fact, showed that most migraine sufferers prefer toughing it out at the office rather than going home to lie in misery while doing nothing.

The study also found that of all employee health problems, migraine ranked behind only back pain and seasonal allergies in frequency.

That finding takes on added significance in that 6 percent of men and 18 percent of women suffer migraine, while 70 percent of the bank’s employees happened to be women.

Gostine told the Business Journal there are ways employees and employers can work to reduce migraine’s personal cost in suffering and its costs to businesses. Unfortunately, he added, many smaller firms don’t have medical resources, so their employees must learn to cope on their own.

But he said most people can cope with migraine. He said the headaches result from cerebral vascular spasms and that those spasms are caused by any number of things, from food allergies to personal stress.

And these are factors that he said migraine sufferers can control to a degree and that the medical staffs at large firms can help with during the follow-up in such cases.

He said a number of products are available to help people deal with the pain, but the key to managing the issue for sufferers is finding and eliminating the causes of the headaches.

Michigan Pain Consultants has developed workbooks and training tapes that business wellness centers can use to help migraine-prone employees follow something like investigative dietary regimens, according to Gostine.

And in cases where stress reduction is needed to manage migraines, he said business wellness centers can reinforce the practical day-to-day recommendations of employees’ psychologists.

Alyssa B. Schultz, a research associate at the U-M Health Management Research Center, conducted the study with Chicago-based Bank One, the nation’s sixth-largest financial services corporation.

Her report indicated that although large epidemiological studies have established the national prevalence of migraines and suggested their huge cost, few employers to date have been able to apply these projections to their specific work force.

The U-M research center worked with Bank One to distribute a health risk appraisal to about 93,000 employees in 2000.

It included queries about chronic disease, including heart disease, diabetes, migraine headache, back pain and cancer.

According to Wayne Burton, M.D., Bank One’s medical director, 21 percent of the firm’s workers returned the questionnaire — that’s nearly 20,000 employees.

Analyzing demographic and payroll data along with the survey responses, the researchers estimated corporate costs due to migraine-related absenteeism and reduced on-the-job productivity to total $21.5 million to $24.4 million for the year, Burton said.

“Of the nearly 20,000 respondents, 20 percent reported a history of migraine headaches,” Schultz said. “Only back pain (34 percent) and seasonal allergies (44 percent) were more frequent than migraine.”

Migraines were prevalent in nearly 8 percent of the men and 23 percent of the women, closely comparable to rates — 6 percent of men and 18 percent of women — reported in national surveys, she said.

“The economic impact of migraine headaches on employers costs is significant,” Schultz added, “because the incidence (of migraine) peaks during the ages of 25 to 55, the prime working years.”

Researchers used data from two prior population-based work loss studies to estimate Bank One’s total migraine-related lost workdays at 118,578 for the year 2000.

Forty percent (46,846) of these were actual days absent and 60 percent (71,732) represented lost efficiency while at work. The findings were published in the June issue of the Journal of Occupational and Environmental Medicine.

“In general, people with migraines say they prefer to go to work and/or stay at work while suffering the headache,” Schultz said. “The cost of reduced efficiency is less visible but very much present.”

Dee Edington, Health Management Research Center director, said: “We are finding in a number of studies that the productivity costs related to what might be called ‘secondary’ chronic diseases, such as migraine headaches, arthritis, allergies and back pain, are equivalent to the medical costs related to such severe conditions as heart disease, stroke, diabetes and cancer.”

What can employers do?

“Work place health care interventions such as occupational health departments and work site disease management programs can save costs by providing education, preventive services and appropriate direct treatment within the work place, where a large part of health-related costs are borne,” Burton said.

“Earlier treatment may reduce the intensity or duration and allow the employee to resume work, even if not fully recovered,” he said. “It is in an employer’s best interests to take a proactive approach to limiting the impact of migraine headaches in the work place.”

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