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Untreated hearing loss linked to higher health costs, more hospitalizations
By Lisa Rapaport
(Reuters Health) - - Older adults with untreated hearing loss may develop additional health problems that lead to more frequent hospitalizations and higher health costs than their counterparts without hearing trouble, two U.S. studies suggest.
One study followed 4,728 people for a decade, starting when they were 61 years old, on average. Half had untreated hearing loss. Over 10 years, this translated into $22,434 more per person in total health costs and over 40 percent higher odds of hospitalizations and repeat admissions.
"There are two potential causes linking hearing loss to higher healthcare spending and utilization," said lead study author Nicholas Reed of the Johns Hopkins University School of Medicine in Baltimore.
"The first is that hearing loss is associated with cognitive decline, dementia, depression, and social isolation - all of which could contribute to higher healthcare spending and use," Reed said by email. "The second is that patient-provider communication could be hampered by untreated hearing loss."
Doctors and patients may not realize that hearing loss contributes to preventable miscommunication about treatment plans, said the author of an accompanying editorial, Dr. Michael McKee of the University of Michigan Medical School in Ann Arbor.
Clinicians should speak directly to patients in a quiet room, follow up to see if they understood and can repeat back what was said, McKee told Reuters Health. There are also portable hearing devices that could be used in hospitals and doctors' offices to help make it easier for patients to communicate with clinicians.
"Patients also need to feel empowered and speak up when they do not understand," McKee said by email. "It is their right to know their health information."
More than 38 million adults in the U.S. have hearing loss, including two-thirds of those over 70, Reed and colleagues note in their report, published in JAMA Otolaryngology-Head & Neck Surgery.
Hearing loss has been linked to a range of health problems including cognitive decline, falls, depression, reduced quality of life and an increased number of hospitalizations and emergency room visits.
A second study in the same journal used insurance claims data to examine associations between hearing impairment and additional health problems among 4,728 adults aged 50 and older, half of whom had been diagnosed with hearing loss.
After five years of follow-up, people with hearing loss but no claims for hearing aids were 50 percent more likely than those without hearing loss to have a new dementia diagnosis and 41 percent more likely to have a new depression diagnosis, compared to people without hearing issues, the study found.
The researchers calculate that over 10 years, 3.2 cases of dementia, 3.6 falls and 6.9 cases of depression per 100 people with one of these diagnoses are attributable to untreated hearing loss.
"What we don't know yet is whether treating hearing loss can help prevent or delay any of these conditions," said lead study author Jennifer Deal of Johns Hopkins University in Baltimore.
Often, people don't get help because they can't afford hearing aids, Deal said by email.
"Hearing aids are incredibly expensive," Deal said. "The average cost per pair in the United States is $4,700 and they are not covered by Medicare."
Proof that treating hearing loss could improve health for older adults might help change this, said David Loughrey of the University of California, San Francisco, and Trinity College Dublin, who wrote an editorial about the study.
"If clinical trials can demonstrate that treatment of hearing loss can help adults maintain their health and delay or prevent dementia this would have significant implications for public health policy," Loughrey said by email. "The cost of treating hearing loss would need to be measured against the cost of treating health conditions such as dementia which is estimated to cost $1 trillion in 2018 globally, increasing to $2 trillion by 2030."
SOURCE: https://bit.ly/2Q1vSHt, https://bit.ly/2Rq1DGZ, https://bit.ly/2DNJzT8 and https://bit.ly/2P5TDbZ JAMA Otolaryngology-Head & Neck Surgery, online November 8, 2018.
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