Join us for PHS 820 featuring Erin Nelson-Bakkum – Differences in CI utilization and distal outcomes by candidacy era.
Please join remotely by Zoom with meeting ID 925 9118 4216 and password 068300 or this URL
Disparities in Cochlear Implant Access and Utilization in Medicare Recipients
Background: Cochlear implants are a highly successful neural prosthesis designed to restore the sense of hearing for individuals with hearing loss who do not benefit from a hearing aid. Despite historic and ongoing efforts that broaden candidacy criteria to make the technology more accessible, there are an estimated 1 million individuals in the United States that meet candidacy criteria for but have not yet received a cochlear implant. This gap is particularly salient for Medicare recipients- for whom candidacy criteria has historically lagged behind private payer insurance- as hearing loss prevalence increases with age. Significant disparities exist in access and utilization of hearing health care across different populations, and non-clinical factors that influence equitable access and utilization of cochlear implants are not well understood. Studies that utilize samples of cochlear implant candidates and/or recipients are valuable for identifying clinical barriers but are inherently limited in that they only reflect the experience of individuals who have already successful accessed hearing health care. Further research is needed to understand the social, geographic, and socioeconomic factors that may play a role in who seeks and ultimately receives a cochlear implant.
Research Question(s): Have historic efforts to broaden cochlear implant candidacy for Medicare recipients been effective in increasing cochlear implant utilization rates? Have historic candidacy expansions disproportionately benefited different populations? Are there social or non-clinical factors that influence the likelihood of an individual with hearing loss to seek an evaluation for a cochlear implant?
Proposed Methods: The proposed study will use linked data from a community-based longitudinal study of older adults and later Medicare claims to evaluate both historic efforts to expand cochlear implant access, and non-clinical factors that influence likelihood of receiving a cochlear implant. This linked dataset of approximately 25,000 older adults will analyze critical information on social and economic backgrounds of cochlear implant recipients not otherwise reported in clinical samples.
Implications: With the overall goal of narrowing the gap between those who need and ultimately receive a cochlear implant, this research will identify non-clinical factors that can be intervened upon that effect the likelihood of receiving a cochlear implant later in life.