Patients With Untreated Hearing Loss Have Higher Health Care Costs
Celebrating 35 years of Caring for Your Hearing
|Meredy Hase tests a child, 1987||Kupperman and Hase work to license audiologists in Wisconsin, 1989|
Hearing Loss UNDER Age 65
We used to think of hearing loss as something that only happened to our grandparents' generation. But you'd be surprised at how many people your age, and even younger, have a hearing problem.
According to a study recently published by the Better Hearing Institute, two-thirds of Americans with hearing loss are under the age of 65 and still in the work force. That includes one of every six "Baby Boomers" (ages 41 to 59) and one of every 14 "Generation X'ers" (age 29-40).
According to Meredy Hase, Doctor of Audiology, "Hearing loss is by no means an 'old person's disease' any longer. Each day, we see people of all ages come into our offices concerned they may have a hearing problem.
"There's even solid evidence to support the fact that for working Americans, hearing loss impacts their ability to make a living, up to $12,000 in lost income per year." (See related article)
Dr. Hase urges anyone who thinks they, or a loved one, may have a hearing loss to contact The Doctors of Audiology at Hearing Services without delay.
Auditory Deprivation refers to the fact that even though we "hear" with our ears, it's our brain that's the true organ of hearing.
When hearing loss is left untreated, the brain's ability to distinguish various sounds becomes less and less. Try to think of Auditory Deprivation as similar, in a sense, to muscles that atrophy when not used over a long period of time.
The reason Auditory Deprivation is important is that we have ample evidence proving how long people will wait before seeking help for a suspected hearing loss. Up to ten years, by some estimates.
In other words, the longer you wait to get help for your hearing loss, the less even the most advanced hearing instruments will be able to help you hear better. That's one more reason physicians recommend annual hearing checks as part of an overall health assessment.
The Doctors of Audiology at Hearing Services can perform hearing screenings that take only a few minutes. Concerned individuals are urged to contact them at the first signs of hearing loss, such as an inability to understand conversations in a crowded room or having to turn up the TV volume in order to hear.
Hearing & Income Loss
After years of research, there is new evidence that links hearing loss and loss of income. A study released by the Better Hearing Institute in Alexandria, VA, proves that untreated hearing loss may impact household income by as much as $12,000 per year.
The study also shows that hearing loss, which affects more than 28 million Americans, two thirds of whom are still in the work force, results in an annual loss of more than $100 billion in wages and worker productivity. The good news is people who find help for their hearing loss can regain up to 50% of that lost income.
According to Meredy Hase, Doctor of Audiology, "One of the misconceptions about hearing loss is that it's 'an old person's ailment'. But we know that hearing loss crosses all income lines and impacts people of all ages".
The new "Open Ear" Digital hearing instruments are especially designed to help Baby Boomers feel more comfortable about wearing hearing instruments.
Anyone interested in receiving a FREE Demonstration of Open Fit hearing technology are urged to contact the Doctors of Audiology at Hearing Services.
Hearing Loss & the Family
For years, both researchers and hearing healthcare professionals have known much about the causes of hearing loss and how it affects the person who suffers from it.
But not until recently has attention been paid as to the devastating effects hearing loss has on family members and friends as well. This past year alone, several organizations have weighed in with their findings on this often overlooked medical problem that by current estimates, affects the lives and families of more than 30 million Americans.
For example, the National Council on Aging (NCOA), a government agency whose task it is to research the lives of older Americans, released a study that confirms how often a person with hearing loss begins to feel isolated, eventually withdrawing from normal everyday activities and even from family and friends.
None of this is news, however, to Dr. Meredy Hase, who says, "I realized just how much hearing loss also affected family members when we''d spend so much time counseling them when we''d fit their loved one with hearing instruments".
The benefits of better hearing were the subject of an NBC report that aired on an installment of the NBC Nightly News. In that report, the testimonials of several patients and their families provided evidence of how lives can be changed for the good, once the decision has been made to seek help for a hearing problem.
Those interviewed talked about how experiences such as watching TV or enjoying conversations with loved ones - things that were not possible with hearing loss - were once again part of the everyday enjoyment of life. Social activities like dining at restaurants of going to the movies were also among the range of family life experienced through better hearing.
Thanks to recent advances in technology more help is available than ever before for those whose lives are affected by hearing loss. If left untreated, hearing loss will almost always become worse over time, another reason Dr. Hase urges people to contact the Doctors of Audiology at Hearing Services if a hearing loss is thought to exist.
More Hearing Healthcare News
Older adults with untreated hearing loss incur substantially higher total health care costs compared to those who don't have hearing loss -- an average of 46 percent, totaling $22,434 per person over a decade, according to a new study led by researchers at the Johns Hopkins Bloomberg School of Public Health. This is one of the largest studies to look at this issue, following many individuals for a full 10 years. The project was done in collaboration with AARP, University of California San Francisco and OptumLabs.
The differences between the two groups were evident as early as two years after diagnosis. Compared to the patients without hearing loss, patients with the condition generated nearly 26 percent more in total health care costs within two years, a gap that widened to 46 percent by 10 years, amounting to $22,434 per individual ($20,403 incurred by the health plan, $2,030 by the individual in out-of-pocket costs). The study did not include patients with hearing loss who had evidence of hearing aid use.
The findings, to be published Nov. 8 in JAMA Otolaryngology-Head and Neck Surgery, add to a growing body of research from Johns Hopkins and elsewhere showing the detriments of untreated hearing loss, which include a higher risk of dementia and cognitive decline, falls, depression and lower quality of life. In a companion paper published in the same issue, a study led by Bloomberg School researchers suggests a link between untreated hearing loss and significantly greater morbidity, affirming early studies.
Hearing loss affects 38 million Americans, a number that's expected to double by 2060, with current aging population trends. An estimated one in three people in the U.S. between the ages of 65 and 74 currently has hearing loss, and two-thirds of adults age 70 years and older have a clinically significant hearing loss.
It's unclear how hearing loss has translated into longitudinal trends of health care utilization and costs, particularly for those whose hearing loss remains untreated, says study lead Nicholas S. Reed, AuD, a member of the core faculty of the Cochlear Center for Hearing and Public Health at the Bloomberg School and an instructor of audiology in the Department of Otolaryngology-Head and Neck Surgery at the Johns Hopkins University School of Medicine.
To investigate these questions, Reed and his colleagues mined information from the OptumLabs Data Warehouse, a large de-identified health care dataset including administrative claims from 1999 to 2016 for people enrolled in large, private U.S. health plans and Medicare Advantage plans. The researchers used diagnosis codes to identify more than 77,000 patients with likely age-related untreated hearing loss, excluding those whose claims data indicated they used a hearing aid or whose hearing loss was secondary to a medical condition or toxic agent such as chemotherapy.
The research team then matched each of these patients with other patients in the claims database on more than 25 factors including demographic characteristics, baseline health conditions and measures of health care utilization, such as inpatient hospitalizations and readmissions within 30 days, emergency department visits, days with at least one outpatient visit and health care costs. The researchers analyzed health care cost and utilization outcomes and trends at two-, five- and 10-year follow-up points.
At the 10-year mark, patients with untreated hearing loss experienced about 50 percent more hospital stays, had about a 44 percent higher risk for hospital readmission within 30 days, were 17 percent more likely to have an emergency department visit and had about 52 more outpatient visits compared to those without hearing loss.
When the researchers calculated how much of the extra $22,434 in total health care costs were likely due solely to hearing loss-related services, the total was only about $600 over 10 years.
The study results do not indicate exactly why untreated hearing loss drives up health care utilization. Reed and his colleagues have a few ideas. One of them is hearing loss' relationship with other serious health issues.
In the companion paper, using the same OptumLabs dataset, Jennifer A. Deal, PhD, assistant scientist in the Bloomberg School's Department of Epidemiology, and her colleagues show that untreated hearing loss is independently associated with significantly greater morbidity. For example, compared to those without hearing loss, those with untreated hearing loss had 3.2 more dementia diagnoses, 3.6 more falls and 6.9 more depression diagnoses per 100 people over 10 years. Over 10 years, those with untreated hearing loss had an estimated 50 percent greater risk of dementia, 40 percent greater risk of depression, and almost 30 percent higher risk for falls compared to those without hearing loss.
"We don't yet know if treating hearing loss could help prevent these problems," Deal says. "But it's important for us to figure out, because over two-thirds of adults age 70 years and older have clinically significant hearing loss that may impact everyday quality of life. We need to better understand these relationships to determine if treatment for hearing loss could potentially reduce risk and help maintain health in older adults."
Deal also noted that the depression finding is important. "There aren't a lot of studies using objectively measured hearing loss showing this association, even though it seems pretty intuitive."
Another possibility for the link between hearing loss and greater health care cost and utilization is that hearing loss might hamper patient-provider communication, says Reed, one of the paper's co-authors. Patients who can't hear their doctors may have trouble communicating their symptoms, participating in conversations to develop a recommended plan for their health or following discharge instructions -- key elements in participating in their own care.
To help improve communication for patients with hearing loss at Johns Hopkins Bayview Medical Center, Reed and others developed a multi-element pilot program to provide extra training to doctors, improve signage or provide hearing amplification devices. The researchers are currently collecting outcomes data associated with these interventions to determine whether they result in better care.
Across the U.S adults with hearing loss will be able to access hearing amplification devices more easily in 2020, when a federal law authorizing certain types of over-the-counter hearing aids will go into effect.
"Knowing that untreated hearing loss dramatically drives up health care utilization and costs will hopefully be a call to action among health systems and insurers to find ways to better serve these patients," says Reed.