https://orcid.org/0000-0001-6770-7105
Abstract
Purpose
Hearing loss has not received sufficient attention, especially in low- and middle-income countries where more than 80% of the people with hearing loss reside. Little is known about the preference for hearing aids among people with hearing loss in developing countries. The aim of this study is to elicit the preferences for hearing aid attributes among rural Chinese adults with moderate or greater hearing loss and examine how preferences vary across different individual socioeconomic characteristics.
Patients and Methods
We interviewed 125 adults in two rural counties in Shandong province in China. A discrete choice experiment (DCE) with eight attributes, comprising out-of-pocket (OOP) costs, hearing aid style, effective in quiet settings and noisy settings, feedback (whistling), connectivity, water/sweat resistance and battery life, were employed to examine participants’ preference for hearing aids. Mixed logit models were used for the statistical analyses.
Results
While OOP costs, effectiveness in quiet settings, water/sweat resistance and battery life were significantly associated with choosing a hearing aid, rural Chinese adults with moderate or greater hearing loss valued effectiveness in noisy settings above other attributes of hearing aids, followed closely by lack of feedback. The preference of the attributes of OOP costs, in the canal hearing aids, effectiveness in noisy settings, connectivity and battery life varied across individual socioeconomic characteristics including sex, marriage, employment, income and education level.
Conclusion
Our study supported the view that the development of noise suppression and feedback cancellation systems remained the main challenge for the hearing aid industry. Since OOP costs were also associated with choosing a hearing aid, the policy advice is to improve reimbursements from insurance schemes and/or reduce the costs of hearing aids.
Abbreviations
YLDs, years lived with a disability; WHO, World Health Organization; WTP, willingness to pay; DCE, discrete choice experimentation; ITE, in the ear; ITC, in the canal; OOP, out-of-pocket.
Data Sharing Statement
The raw data (transcripts) of this study cannot be shared, to maintain participant privacy. Summary data are available from the corresponding author on reasonable request.
Ethics and Consent Statement
The study was approved by the Ethics Committee of Peking University (No. IRB00001052-19046). Participants’ informed written consent was obtained for the study contents, purposes, protocols, data confidentiality and anonymity procedures, and participants’ freedom to discontinue the study at any stage was explained and consent agreed.
Author Contributions
Dawei Zhu: study design, field investigation, data analysis, and drafting the manuscript. Xin Ye, Siyuan Chen and Xuefeng Shi: participating the study design, field investigation and revising the manuscript. Stephen Nicholas: revising the manuscript and contributing the language editing of the manuscript. Ping He: study concept and design, critical revision of the manuscript, and supervising all aspects of the work. All authors contributed to data analysis, drafting or revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest in this work.