Objective: Adults with hearing loss are at risk of negative impacts of the pandemic. Specific factors, such as hearing loss severity and location of residence, may disproportionately impact patients during the pandemic. The objective of this study was to assess the relative impact of the COVID-19 pandemic on hearing loss patients, based on hearing device type and location of residence. Study Design: Prospective cross-sectional questionnaire study. Setting: Tertiary referral center. Patients: Adults with hearing loss. Main Outcome Measures: Data included sociodemographic data, communication challenges, pandemic preparedness, access to healthcare, and mental and emotional health. Results: A total of 614 patients responded (27.8% response rate). Compared with hearing aid users, cochlear implant users reported more difficulty communicating with family/friends (53% versus 41%, p ¼ 0.017), obtaining pandemic information (10% versus 3%, p ¼ 0.002), and understanding live broadcasts (47% versus 17%, p ¼ 0.001) during the pandemic. CI users were less likely than hearing aid users to seek general (52% versus 69%, p ¼ 0.001) and hearing healthcare services (20% versus 34%, p ¼ 0.002). Rural residents reported greater difficulty than urban residents communicating with friends/ family (53% versus 39%, p ¼ 0.001), obtaining food/supplies (41% versus 20%, p ¼ 0.004), understanding live broadcasts (31% versus 20%, p ¼ 0.001) during the pandemic. Compared with urban residents, rural residents reported greater difficulty accessing general (57% versus 42%, p ¼ 0.004) and hearing healthcare (49% versus 34%, p ¼ 0.043). Rural residents reported poorer mental/emotional health than urban residents. Conclusions: Among adults with hearing loss, cochlear implant users and rural residents experience greater challenges in communication, pandemic preparedness, and access to healthcare during the COVID-19 pandemic.
Objectives Access to and utilization of perioperative healthcare may influence outcomes in patients with chronic suppurative otitis media (CSOM); however, the influencing factors are poorly understood. The objective of this study was to assess the association of sociodemographic factors with perioperative health care utilization for pediatric CSOM patients. Methods We conducted a review on pediatric CSOM patients (≤18 years old) who underwent tympanoplasty with/without mastoidectomy between 2010 and 2020. Sociodemographic data and clinical were collected on all participants. Univariate and multivariate logistic regression analysis was conducted to assess the association between these factors and perioperative care utilization. Results 427 patients were included in the study. The primary factor associated with health care utilization was insurance status. Rural children were more likely to have Medicaid insurance (p = 0.048). For tympanoplasty patients, Medicaid patients have 1.66 higher odds of pre‐operative no‐shows (p = 0.01), 1.31 higher odds of post‐operative no‐shows (p = 0.02), and 59% lower odds of having a postoperative audiogram (p = 0.01), and 2.64 higher odds of being from a rural community (p = 0.02). For patients undergoing mastoidectomy, Medicaid patients have 1.25 higher odds of postoperative no‐shows (p = 0.01), 39% lower odds of having a revision procedure for ossicular reconstruction (p = 0.045). Appalachian rural mastoidectomy patients had 3.62 higher odds of having cholesteatoma (p = 0.05). Conclusion Pediatric patients with CSOM who have Medicaid insurance, especially those who reside in rural regions, are at risk for lower perioperative hearing health care utilization. As these findings may impact care delivery and clinical outcomes, efforts should be focused on promoting utilization among these populations. Level of Evidence 4 Laryngoscope, 133:700–705, 2023
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