Cost-effective hearing aid delivery models: Outcomes, value, and candidacy

具有成本效益的助听器交付模式：结果、价值和候选资格

• 批准号: 9915882
• 负责人: Yu-Hsiang Wu
• 金额: $ 32.39万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-05-08 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9915882
• 关键词: Adoption; Adult; Advocacy; Advocate; American; Behavioral; Clinical; Communication; Cost Effectiveness Analysis; Counseling; Data; Devices; Double-Blind Method; Ear; Ensure; Evaluation; Frequencies; Goals; Guidelines; Health Personnel; Healthcare; Hearing; Hearing Aids; Hearing Tests; High Prevalence; Human; Hybrids; Individual; Intervention; Knowledge; Learning; Low income; Measures; Mission; Modeling; National Institute on Deafness and Other Communication Disorders; Outcome; Patient Care; Patient Self-Report; Patients; Personality; Practice Management; Presbycusis; Procedures; Professional Role; Public Health; Quality of life; Randomized; Randomized Controlled Trials; Reporting; Research; Service delivery model; Services; Site; Testing; United States National Institutes of Health; amplification device; base; cognitive function; cost; cost effective; design; effective intervention; ethnic minority population; hearing impairment; improved; outcome prediction; patient oriented; psychosocial; racial minority; randomized controlled study; response; self diagnosis; yeast two hybrid system

PROJECT SUMMARY/ABSTRACT Age-related hearing loss is a substantial national problem due to its high prevalence and significant psychosocial consequences. Although hearing aids (HAs) are the primary intervention for the management of age-related hearing loss, only 15–30% of those who could benefit from HAs actually seek them out. HA adoption rates are even worse for people with lower income and for racial and ethnic minorities. One of the most commonly reported reasons for people not seeking HA intervention is the high cost of HAs and the associated audiological fitting services. Because HAs fitted using the audiologist-based service-delivery model (AUD model) are unaffordable, more and more Americans (1.5 million in 2010) purchase amplification devices via over-the-counter service-delivery models (OTC models) to compensate for their impaired hearing. Although OTC amplification devices are gaining popularity and are regarded as an important option for promoting accessible and affordable hearing healthcare, it is unclear if they are viable solutions for age-related hearing loss as OTC models exclude professional services. Further, if there are outcome differences between AUD and OTC models, it is unknown if the clinical improvement in outcomes will be offset by the improved value (outcome relative to cost), or if it is possible to identify appropriate candidacy for each model to ensure optimal patient care for all. Finally, no prior research has investigated if “hybrid” service-delivery models, in which professionals provide streamlined services to fit OTC amplification devices, offer affordable and quality amplification interventions as has been recently advocated. The overall goal of this project is to characterize the differential effect of service-delivery models on provision of amplification so that accessible and affordable hearing healthcare can be facilitated. This project proposes to conduct research that would provide new knowledge about the outcome, value, and candidacy of OTC, hybrid, and AUD models and the effect of professional evaluation/selection services, patient- centered services, and device-centered services on outcome and value. The proposed study will acquire this knowledge through a two-site, double-blinded, randomized controlled field trial. The results obtained will inform patients and hearing healthcare providers about what can be achieved with different service-delivery models, and will help us develop guidelines to facilitate the selection of the most appropriate and cost-effective intervention for a particular patient. The significance of the proposed project from the public health point of view is that it will facilitate not only accessible and affordable, but also quality, hearing healthcare.

项目总结/文摘