Patient Satisfaction in the Headache Care at the Veterans Health Administration Headache Centers of Excellence: A Cross-Sectional Study

This cross-sectional study compared patient satisfaction with headache care in Veterans Health Administration (VHA) Headache Centers of Excellence (HCoE) and HCoE facilities versus traditional headache care. Using the VHA Survey of Healthcare Experiences of Patients specialty care survey, we analyzed responses from 4317 (14% response rate) veterans with a VHA headache visit who received care from (1) a Veterans Affairs (VA) HCoE provider; (2) a non-HCoE provider within a VA medical center containing an HCoE; or (3) a provider in a VA medical center without an HCoE. Compared to patients at non-HCoE facilities, both HCoE patients and HCoE facility patients reported higher overall satisfaction with their VHA care in general (OR = 1.32, 95% CI = 1.05-1.64; OR = 1.46, 95% CI = 1.38-1.54), respectively. Despite a modest response rate, HCoE and HCoE facility patients reported significantly higher satisfaction across other domains including access and communication, in models adjusting for demographics. These findings advance the conversation regarding the value of HCoEs in delivering high-quality, patient-centered care and expanding HCoE resources may improve satisfaction. Future research should formally investigate methods of improving satisfaction.