Abstract
Data from a pilot population study of hearing impairment give a high estimate (10%) for the prevalence of clinically significant hearing loss in the UK. This carries implications for the nature of further research, in particular that within the National Study of Hearing conducted by the Institute of Hearing Research. It also carries important implications for the scale and nature of audiological services, the projected need for which could not be met by present audiological staffing. Service-monitoring data obtained in ENT outpatient and hearing-aid clinic populations suggest that only about one-half of the potential numbers receive help from the Health Service. In particular prevailing criteria for referral, while referring absolutely more elderly than younger people, still do not parallel the progression of audiometric impairment in the population.
The large short-fall in referral plus technological progress suggest that a large absolute growth in service take-up could come from the mildly impaired in the near future. Considerations of secondary prevention of disability argue that many more such referrals should be encouraged. The moderately impaired are those chiefly catered for by the present service. Some growth in demand is possible here also: the number of patients in this band is already large enough that a more adequate and diverse service can be delivered without greatly increasing the average cost per patient. Services for the severely impaired are already improving as a result of trends in research and service development but further service improvements carry cost implications. Hence the relatively sparse information on prevalence and service uptake in this band needs to be enhanced by further research. Growth in demand among the moderately and the severely impaired is likely to depend more on enlarged service roles and on changing age structures rather than upon changes in referral processes and criteria.