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 Researchers examined Medicare payment data collected in 2013 and
2014 for 1,336 adults 65 and older with hearing loss. Overall, 734
people, or 55 percent, didn't wear hearing aids.
During the study period, 24 percent of people with hearing aids and
26 percent of those without the devices visited an emergency room at
least once, the study found. With hearing aids, 20 percent of people
were hospitalized, compared to 22 percent without the devices.
With hearing aids, however, healthcare costs were not necessarily
lower: more people with the devices had at least one check up at a
clinic or doctor's office, and people with hearing aids also
averaged 1.4 more doctor visits than those without the devices.
"We hypothesize that use of hearing aids helps individuals with
severe hearing loss to communicate better with their physicians and
to have a more active lifestyle compared with those who do not use
hearing aids," said lead study author Elham Mahmoudi of the
University of Michigan in Ann Arbor.
Hearing aids were also associated with $1,125 more a year in total
healthcare costs, as well as $325 more in annual out-of-pocket
spending for patients, the study found.
This was unexpected, Mahmoudi said by email.
"However, the $1,125 estimated increase in healthcare costs
associated with hearing aids was below the average $2,000 to $7,000
price of hearing aids," Mahmoudi added.
Medicare, the U.S. health insurance program for people 65 and older,
doesn't cover hearing aids even though an estimated two-thirds of
elderly people have hearing loss by age 70, the researchers note in
JAMA Otolaryngology-Head & Neck Surgery.
Hearing loss is a major cause of poor communication for older
adults, which can result in lower patient satisfaction, less
compliance with prescribed medications and recommended treatments,
more utilization of health services and higher medical costs, the
study authors write.
While hearing aids were associated with higher total healthcare
spending and out-of-pocket costs for patients, the devices were also
linked to $71 less in annual Medicare spending, the study found.
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"Financial barriers to obtaining and fitting hearing aids are noted
as the main reasons people with hearing loss do not use them,"
Mahmoudi said. "In deciding on insurance coverage for hearing aids,
insurance companies and the Centers for Medicare and Medicaid should
consider the long-term efficacy of these devices."
The study wasn't a controlled experiment designed to prove whether
or how hearing aids might directly impact health use, costs or
patient outcomes.
Another drawback is that researchers lacked objective data on the
severity of hearing loss, relying instead on information reported by
patients in a survey.
Even when people do get hearing aids, they may wear the devices for
varying amounts of time during a typical day or choose to use them
in different settings and circumstances, noted Margaret Wallhagen of
the University of California, San Francisco. These things may all
impact how much hearing aids contribute to patient health or
utilization of healthcare services, Wallhagen, author of an
accompanying editorial, said by email.
"Trying to determine the reason for lower ER visits and
hospitalizations is, unfortunately, rather speculative," Wallhagen
said. "In this sample, those without hearing aids had somewhat
higher rates of chronic conditions and fewer economic resources and
may be more likely to use ERs as a source of health care but we
definitely need additional data to elucidate the effects of hearing
aids on healthcare use."
SOURCE: https://bit.ly/2HZVjoG and https://bit.ly/2rBvqSb JAMA
Otolaryngology- Head & Neck Surgery, online April 26, 2018.
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