Trends in Health Care Costs and Utilization Associated With Untreated Hearing Loss Over 10 Years

Reed, Nicholas; Altan, Aylin; Deal, Jennifer A.; Yeh, Charlotte S.; Kravetz, Alexander D.; Wallhagen, Margaret; Lin, Frank R.

doi:10.1001/jamaoto.2018.2875

Cited by 174 publications

(177 citation statements)

References 32 publications

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“…18 Under these frameworks, CI users underperform not because they struggle to perceive the information, which then impacts storage and retrieval, but because of differences in brain networks. We found that our participants correctly repeated 94.70% of the words, on average, across the first and second encoding trials on the stan- 38 Early detection and intervention of dementia could mitigate some of these accrued costs.…”

Section: Discussionmentioning

confidence: 80%

“…Our results affirm the construct validity of the HI‐MoCA, which provides an alternate version to screen for dementia. Having an alternative format is important because of how common it is for individuals to have untreated HL, which is associated with greater health care costs and more hospitalizations . Early detection and intervention of dementia could mitigate some of these accrued costs.…”

Section: Discussionmentioning

confidence: 99%

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Performance on the standard and hearing‐impaired Montreal Cognitive Assessment in cochlear implant users

Parada

Hillyer

Parbery‐Clark

2020

Int J Geriat Psychiatry

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Objectives Commonly used cognitive screening tools were not originally developed for patients with hearing loss (HL) and rely heavily on the ability to hear the instructions and test stimuli. Recently, the Montreal Cognitive Assessment (MoCA) was modified for use with hearing‐impaired populations (ie, HI‐MoCA). In order to investigate the clinical utility of the HI‐MoCA, we assessed performance between the standard MoCA and HI‐MoCA among postlingually deafened cochlear implant (CI) users. Methods We administered the standard MoCA and HI‐MoCA to 21 CI users and compared their performance. We assessed differences in pass/fail status when items from the attention and language sections and the delayed recall task were removed. Results There was no significant difference in performance between the standard MoCA and HI‐MoCA. Participants scored higher on both test versions when the delayed recall task was removed. Participants also performed better on the delayed recall task on the HI‐MoCA than on the standard MoCA. Conclusions While our findings suggest that the modality of presentation for the MoCA does not influence overall performance for postlingually deafened CI users, visual presentation of stimuli impacted performance on delayed recall. Furthermore, irrespective of presentation modality, our participants scored higher on both MoCA versions when the delayed recall task was removed. Clinically, modifications to the presentation of the MoCA might not be necessary for CI users; however, clinicians should be aware that the delayed recall task is inherently harder for these patients.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Performance on the standard and hearing‐impaired Montreal Cognitive Assessment in cochlear implant users

Parada

Hillyer

Parbery‐Clark

2020

Int J Geriat Psychiatry

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“…Hearing loss presents a significant global health burden as the 4 th leading contributor to years lived with disability (Vos et al 2016). Mounting evidence demonstrates significant associations between hearing loss, depression (Fellinger et al 2012), unemployment (Ruben 2015), risk for hospitalization (Genther et al 2013;Reed et al 2018) and cognitive decline and dementia (Lin et al 2011;Livingston et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Improving Sensitivity of the Digits-in-Noise Test using Antiphasic Stimuli

Sousa

Swanepoel

Moore

et al. 2019

Preprint

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Objective: The digits-in-noise test (DIN) has become increasingly popular as a consumer-based method to screen for hearing loss. Current versions of all DINs either test ears monaurally or present identical stimuli binaurally (i.e., diotic noise and speech, NoSo). Unfortunately, presentation of identical stimuli to each ear inhibits detection of unilateral sensorineural hearing loss (SNHL), and neither diotic nor monaural presentation sensitively detects conductive hearing loss (CHL). Following an earlier finding of enhanced sensitivity in normally hearing listeners, this study tested the hypothesis that interaural antiphasic digit presentation (NoSπ) would improve sensitivity to hearing loss caused by unilateral or asymmetric SNHL, symmetric SNHL, or CHL. Design:This cross-sectional study, recruited adults (18-84 years) with various levels of hearing, based on a four-frequency pure tone average (PTA) at 0.5, 1, 2 and 4kHz.The study sample was comprised of listeners with normal hearing (n=41; PTA ≤ 25 dB HL in both ears), symmetric SNHL (n=57; PTA > 25 dB HL), unilateral or asymmetric SNHL (n=24; PTA > 25 dB HL in the poorer ear) and CHL (n=23; PTA > 25 dB HL and PTA air-bone gap ≥ 20 dB HL in the poorer ear). Antiphasic and diotic speech reception thresholds (SRTs) were compared using a repeated-measures design.Results: Antiphasic DIN was significantly more sensitive to all three forms of hearing loss than the diotic DIN. SRT test-retest reliability was high for all tests (ICC r > 0.89).Area under the receiver operating characteristics (ROC) curve for detection of hearing loss (> 25 dB HL) was higher for antiphasic DIN (0.94) than for diotic DIN (0.77) presentation. After correcting for age, PTA of listeners with normal hearing or symmetric SNHL was more strongly correlated with antiphasic (rpartial[96]=0.69) than diotic (rpartial=0.54) SRTs. Slope of fitted regression lines predicting SRT from PTA was significantly steeper for antiphasic than diotic DIN. For listeners with normal hearing or CHL, antiphasic SRTs were more strongly correlated with PTA (rpartial[62]=0.92) than diotic SRTs (rpartial[62]=0.64). Slope of regression line with PTA was also significantly steeper for antiphasic than diotic DIN. Severity of asymmetric hearing loss (poorer ear PTA) was unrelated to SRT. No effect of self-reported English competence on either antiphasic or diotic DIN among the mixed first-language participants was observed 3 Conclusions: Antiphasic digit presentation markedly improved the sensitivity of the DIN test to detect SNHL, either symmetric or asymmetric, while keeping test duration to a minimum by testing binaurally. In addition, the antiphasic DIN was able to detect CHL, a shortcoming of previous monaural or binaurally diotic DIN versions. The antiphasic DIN is thus a powerful tool for population-based screening. This enhanced functionality combined with smartphone delivery could make the antiphasic DIN suitable as a primary screen that is accessible to a large global audience.

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“…Hearing loss is independently associated with accelerated cognitive decline, dementia, falls, and reduced quality of life . Notably, recent studies have demonstrated that hearing loss burdens individuals, as well as the healthcare system, with increased healthcare utilization and spending …”

mentioning

confidence: 99%

“…7 Notably, recent studies have demonstrated that hearing loss burdens individuals, as well as the healthcare system, with increased healthcare utilization 8 and spending. 9 Importantly, the causal pathways between hearing and negative health outcomes may be modifiable via hearing care. Recent evidence suggests hearing aid use may mitigate the impact of hearing loss on cognitive decline, 10 healthcare costs, and utilization.…”

mentioning

confidence: 99%

Cost‐Benefit Analysis of Hearing Care Services: What Is It Worth to Medicare?

Willink

Reed

Lin

2019

J American Geriatrics Society

Self Cite

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Objective Hearing care services for older adults with hearing aids are underutilized and are not covered by the Medicare program. Little information exists to the value of hearing care services for older adults with hearing aids. The objective of this analysis is to estimate the potential costs and benefits to the Medicare program of covering hearing care services. Design Cross‐sectional analysis using propensity score matching methods to create balanced and comparable groups. We conducted a 1:1 match of older Medicare beneficiaries with hearing aids who self‐reported use of hearing care services in the previous 12 months to those with hearing aids who did not use hearing care services. Groups were balanced on demographic and socioeconomic characteristics as well as health status, functional impairment, and trouble hearing. We compared average total Medicare spending per person between matched groups, as well as by service type. Setting Nationally representative survey of Medicare beneficiaries in the United States (Medicare Current Beneficiary Survey) 2013. Participants Study participants were limited to those in the survey who reported using hearing aids in 2013 (n = 1120). Results Average annual Medicare spending was $8196 (95% confidence interval [CI] = $6670‐$9723) among Medicare beneficiaries who used hearing care services and $10,709 (95% CI = $8878‐$12,541) among matched controls who did not use hearing care services. Total spending per person was $2513 (95% CI = $150‐$4876) higher among those who did not use hearing care services, with spending differences driven mostly by higher‐skilled nursing facility (difference = $825; 95% CI = $193‐$1455) and home health (difference = $287; 95% CI = $7‐$568) spending among matched controls. Conclusion Utilization of hearing care services among older adults with hearing aids is associated with reduced Medicare spending. Increasing access to hearing care services among Medicare beneficiaries with hearing aids may provide value to the healthcare system and net savings to the Medicare program. J Am Geriatr Soc 67:784–789, 2019.

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Trends in Health Care Costs and Utilization Associated With Untreated Hearing Loss Over 10 Years

Cited by 174 publications

References 32 publications

Performance on the standard and hearing‐impaired Montreal Cognitive Assessment in cochlear implant users

Performance on the standard and hearing‐impaired Montreal Cognitive Assessment in cochlear implant users

Improving Sensitivity of the Digits-in-Noise Test using Antiphasic Stimuli

Cost‐Benefit Analysis of Hearing Care Services: What Is It Worth to Medicare?

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