Early Audiology Referral in Primary Care

改善初级保健中的听力保健 项目总结/摘要 听力损失（HL）在美国诊断不足，转诊听力学 专家的利用不足，相对较少的HL患者使用助听器。的 本研究的目的是探索使用自动化电子工具的可行性， 提高为轻度至中度听力障碍患者提供的听力保健质量 HL。这项研究的独特之处在于它侧重于初级保健的检测和转诊 水平先前的研究表明，许多HL患者的生活时间更长， 十年以上，不接受治疗，直到HL进展到 中度至重度水平，导致严重不良后果。最主要 护理医生（PCP）目前不筛查HL。这是由于几个原因 包括对HL的理解不足和初级保健的高度复杂性， 使管理较少认识到的慢性疾病变得困难。初步 研究表明，助听器的使用随着系统的建立而改善， 提高HL的检测和PCP转诊，从而提高识别和 这些病人的转诊有很大的潜力降低发病率。然而，尽管如此， 在这一竞技场中仍然存在重要问题。具体地说， (1)新兴的创新医疗保健提供方法在多大程度上可以 为初级保健环境开发的药物可用于普遍增加HL 筛查和检测率在患者中最有可能经历它？ (2)这能在多大程度上提高听力学的转诊率 专家？ (3)患者是否被转诊进行HL检测？ 在这项研究中，我们将采用已用于更“可见”慢性疾病的工具。 糖尿病等疾病-电子临床管理工具， 教育干预，以及与听力学家的团队合作，以确定 这些方法是否也能增加对不太明显但常见的五氯苯酚的评估 慢性疾病，如听力损失。特别是，我们将评估这些 帮助PCP更好地评估和早期识别HL，并转诊此类患者 在适当的时候，听力学专家。结果也将提供社区- 基于数据，为HL患者的医疗保健提供未来研究提供信息 作为对其他未被充分认识的慢性疾病的护理。

Improving Hearing Health Care In Primary Care Project Summary/Abstract Hearing loss (HL) is under-diagnosed in the United States, referral to audiology specialists is underutilized, and relatively few individuals with HL use hearing aids. The goal of this research is to explore the feasibility of using automated electronic tools to improve the quality of hearing health care provided to patients with mild to moderate HL. The study is unique in that it focuses on detection and referral at the primary care level. Previous research has shown that many individuals with HL live with it for more than ten years and do not receive treatment until the HL has progressed to the moderate-to-severe levels, with resulting significant adverse sequalae. Most primary care physicians (PCP) do not currently screen for HL. This is due to several reasons including a poor understanding of HL and the high complexity of primary care that makes management of less-recognized chronic conditions difficult. Preliminary research suggests that hearing aid use improves following establishment of systems to improve detection of HL and referral by PCP, so improving the identification and referral of these patients has great potential for decreasing morbidity. Nevertheless, important questions remain in this arena. Specifically, (1) To what extent can emerging innovative health care delivery methodologies developed for primary care settings be used to universally increase HL screening and detection rates among patients most likely to experience it? (2) To what extent can this improve the referral rate to audiology specialists? (3) Are patients referred for HL testing actually having it done? In this study, we will employ use of tools that have been used for more"visible" chronic conditions such as diabetes - electronic clinical management tools, targeted educational interventions, and a team-based approach with audiologists - to determine whether these methods can also increase PCP evaluation for less visible but common chronic conditions such as hearing loss. In particular, we will assess whether these help PCPs better assess and make early identification of HL, and refer such patients when appropriate to audiology specialists. The results will also provide community- based data to inform future studies of health care delivery for patients with HL as well as care for other under-recognized chronic conditions.