TY - JOUR
T1 - Racial and Ethnic Disparities among Hearing Aid and Cochlear Implant Patients at a Tertiary-Level Academic Otology Practice
AU - Casazza, Julia A.
AU - Mitton, Tanner J.
AU - Yancey, Kristen L.
AU - Whitson, Johanna J.
AU - Hunter, Jacob B.
N1 - Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2023/6/1
Y1 - 2023/6/1
N2 - Objective Utilization of hearing aids (HAs) and cochlear implants (CIs) is limited, with our group previously demonstrating that non-White patients pursue CI less than White patients. The aim of this study was to compare the demographic makeup of patients more recently evaluated for both interventions in our clinic, exploring the influence of insurance on pursuit of HA, and whether changes have occurred in CI uptake. Study design Retrospective chart review. Setting Tertiary-level academic otology clinic. Methods All patients (18 yr or older) evaluated for an HA or CI in 2019 were included. Demographic variables (including race, insurance, and socioeconomic status) were compared between patients who did and did not obtain an HA or CI. Results In 2019, 390 patients underwent an HA evaluation, and 195 patients received a CI evaluation. Relative to patients evaluated for CI, patients evaluated for HA were more likely to be White (71.3% versus 79.4%, p = 0.027). Examining factors that affected HA purchase, Black race (odds ratio, 0.32; 95% confidence interval, 0.12-0.85; p = 0.022), and lower socioeconomic status (odds ratio, 0.99; 95% confidence interval, 0.98-1.00; p = 0.039) were associated with decreased odds. Demographic variables and AzBio quiet scores were not associated with decision to pursue CI surgery. Conclusions White patients comprised a larger proportion of HA evaluations than CI evaluations. Furthermore, White patients and those of higher socioeconomic status were more likely to purchase HA. Improved outreach and expanded insurance benefits for HA are needed to ensure equal access to aural rehabilitation.
AB - Objective Utilization of hearing aids (HAs) and cochlear implants (CIs) is limited, with our group previously demonstrating that non-White patients pursue CI less than White patients. The aim of this study was to compare the demographic makeup of patients more recently evaluated for both interventions in our clinic, exploring the influence of insurance on pursuit of HA, and whether changes have occurred in CI uptake. Study design Retrospective chart review. Setting Tertiary-level academic otology clinic. Methods All patients (18 yr or older) evaluated for an HA or CI in 2019 were included. Demographic variables (including race, insurance, and socioeconomic status) were compared between patients who did and did not obtain an HA or CI. Results In 2019, 390 patients underwent an HA evaluation, and 195 patients received a CI evaluation. Relative to patients evaluated for CI, patients evaluated for HA were more likely to be White (71.3% versus 79.4%, p = 0.027). Examining factors that affected HA purchase, Black race (odds ratio, 0.32; 95% confidence interval, 0.12-0.85; p = 0.022), and lower socioeconomic status (odds ratio, 0.99; 95% confidence interval, 0.98-1.00; p = 0.039) were associated with decreased odds. Demographic variables and AzBio quiet scores were not associated with decision to pursue CI surgery. Conclusions White patients comprised a larger proportion of HA evaluations than CI evaluations. Furthermore, White patients and those of higher socioeconomic status were more likely to purchase HA. Improved outreach and expanded insurance benefits for HA are needed to ensure equal access to aural rehabilitation.
KW - Cochlear implant
KW - Health disparities
KW - Hearing aid
KW - Hearing loss
KW - Social determinants of health
UR - http://www.scopus.com/inward/record.url?scp=85159373331&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85159373331&partnerID=8YFLogxK
U2 - 10.1097/MAO.0000000000003869
DO - 10.1097/MAO.0000000000003869
M3 - Article
C2 - 37026798
AN - SCOPUS:85159373331
SN - 1531-7129
VL - 44
SP - E328-E332
JO - Otology and Neurotology
JF - Otology and Neurotology
IS - 5
ER -