Cochlear implantation in the world's largest medical device market: Utilization and awareness of cochlear implants in the United States

Abstract

Provision of cochlear implants (CIs) for those within the criteria for implantation remains lower in the United States than in some other developed nations. When adults and children are grouped together, the rate of utilization/provision remains low at around 6%. For children, the provision rate is about 50% of those who could benefit from an implant, compared with figures of about 90% for the Flanders part of Belgium, the United Kingdom and other European countries. The probable reasons for this underprovision include: low awareness of the benefits of CIs among the population; low awareness among health-care professionals; the lack of specific referral pathways; some political issues relating to the Deaf Community; and financial issues related to health provision. Such financial issues result in situations which either fail to provide for access to implants or provide too low a level of the necessary funding, especially for low-income individuals covered by public health-care programs such as Medicaid. These issues might be mitigated by adoption and publication of standards for best clinical practices for CI provision, availability of current cost-effectiveness data, and the existence of an organization dedicated to cochlear implantation. Such an organization, the American Cochlear Implant Alliance (ACI Alliance), was recently organized and is described in the paper by Niparko et al. in this Supplement.

Cochlear Implant Access in Six Developed Countries

“…Two countries were the exception to the high pediatric utilization: 1) in Germany, CI utilization by young children is approximately 65%, largely because of counseling issues and 2) in the United States, pediatric utilization was cited as 50% by one panelist calculated from national prevalence estimates (3).…”

Cochlear Implantation, Enhancements, Transhumanism and Posthumanism: Some Human Questions

“…In medicine, ''standard of care'' means the formal process of evidence-based diagnosis and treatment which a physician follows for a patient with a particular syndromes or illness. Yet, in the world's largest medical device market, Some Human Questions… the United States, the CI utilization rate for children with a suitable audiological profile is around 50 % compared to less than 5 % utilization by appropriate adults (Sorkin 2013). Such underutilization rates have not changed much over time except in the pediatric age group.…”

The Prevalence and Impact of Vision and Hearing Loss in the Elderly

“…The system bypasses a damaged auditory system to directly stimulate a functioning auditory nerve. Although extensive research has demonstrated the safety and effectiveness of this system, only 5%-7% of adults who qualify for cochlear implantation in the US receive a CI [6]. It is not known whether this low percentage is due to lack of awareness, limited access to appropriate care, or some other cause.…”