Hearing aid utilization in Ontario – a population based study

Abstract

Background

Hearing loss is one of the most common sensory impairments and hearing aids are the most common unmet assistive device need among individuals with a disability. The benefits of hearing interventions are well-documented as they are known to deter the sequalae of hearing loss including social isolation, poor mental health, falls and cognitive decline. Identifying trends in hearing aid users can provide valuable information for improving access to hearing loss interventions.

Methods

Data were retrieved from ICES databases that were used to generate a cohort of 372,448 individuals in Ontario, Canada, who first claimed hearing aids between April 2007 and March 2018 through the Assistive Devices Program.

Results

The data indicated that the frequency distribution of hearing aids has steadily inclined since 2007. The mean age of hearing aid users was 70.25 ± 14.70 years and higher neighbourhood income quintile was associated with greater hearing aid use (p < 0.001). Most first claims occurred after visiting primary care physicians (70.60%) compared with otolaryngology (13.39%). An examination of clinical comorbidities revealed hypertension (63.41%), and diabetes (24.93%) to be the most common. Regression analysis demonstrated a positive associated between age and most comorbidities. Furthermore, higher neighbourhood income quintiles were associated with a reduced risk of having the examined comorbidities.

Conclusions

This study examines patient demographics and clinical comorbidities in a cohort of hearing aid users in Ontario. The results identify associations between demographics and comorbidities that provide information relevant for improving access to hearing interventions and clinical decision-making in primary care.

Implications for Rehabilitation

• Screening for hearing loss (using an audiogram) in elderly individuals that manage multiple comorbidities, and any patient with significant risk factors for hearing loss (e.g., noise exposure history, prior ototoxic medications, prior head injury, history of ear surgery, family history of hearing loss) will identify deficits and direct appropriate hearing interventions.

• Improving access to care in low-income communities should include community-based education around expectation management and communication strategies to reinforce proper use and care of hearing devices.

• Geographic proximity to hearing testing facilities and hearing aid dispensaries is a significant barrier to hearing rehabilitation strategies.

Keywords:

• Hearing loss
• hearing aids
• rehabilitative hearing device

Acknowledgments

1. This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health (MOH) and the Ministry of Long-Term Care (MLTC). Parts of this material are based on data and information compiled and provided by: MOH and CIHI. The analyses, conclusions, opinions and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred.

2. The dataset was cut at ICES Queen’s (Kingston, Ontario). The dataset creation and data analysis was performed at ICES Queen’s by Dr. Paul Nguyen.

Ethical approval

This study was approved by the Queen’s University Health Sciences & Affiliated Teaching Hospitals Research Ethics Board (HSREB), project #6025803.

Disclosure statement

Jason A. Beyea has a proprietary interest in the Kingston Ear Institute Inc. This is a multidisciplinary clinic that provides diagnostic and therapeutic services/products for vestibular loss, imbalance, and hearing loss.

Additional information

Funding

SEAMO New Clinician Scientist Program Research Establishment Funding. The funding body had no role in the design of the study, or the data collection/analysis/interpretation, or in the writing of the manuscript.