Friday, November 23, 2018

Another reason to not ignore hearing loss: Study shows it will likely cost you more in health-care expenses

Untreated hearing loss in older adults affects more than just their ability to communicate. It can also increase their health-care expenses.

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A Johns Hopkins Bloomberg School of Public Health study found that older adults with untreated hearing loss pay an average of 46 percent more -- or $22,434 more -- for health care over a decade, compared to those who have no hearing loss.

“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,” lead author Nicholas Reed said in a news release.

Reed is 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.

The study, published in JAMA Otolaryngology-Head and Neck Surgery, saw differences as early as two years after diagnosis, with the patients who had untreated hearing loss showing a 26 percent increase in total health-care costs, more than half the difference found after 10 years. Of the 46 percent increase after 10 years, an average $20,403 of it was incurred by the patient's health insurer and $2,030 by the patient in out-of-pocket costs, the study found.

The findings "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," says the release. It notes that hearing loss affects 38 million Americans, a number that’s expected to double by 2060. One in three Americans between 65 and 74 has hearing loss, and two-thirds of adults 70 and older have a clinically significant loss.

Nearly 700,000 Kentuckians have hearing loss, or about 16 percent of the commonwealth's citizens, according to the Kentucky Commission on the Deaf and Hard of Hearing. Click here to see how many people in your county have hearing loss.

How the study was done, and what might be done in response

Using data from OptumLabs Data Warehouse, the researchers identified more than 77,000 patients with likely age-related untreated hearing loss, excluding those who used a hearing aid or whose hearing loss was secondary to another condition.

An in-depth analysis found that after 10 years, "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," the release says. And of the extra $22,434 in total health care costs, only about $600 was due solely to hearing loss-related care.

The study did not indicate why untreated hearing loss drives up health-care costs, but the release notes that a companion paper using the same data found that hearing loss is independently associated with "significantly greater" incidence of disease.

"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," says the release.

“We don’t yet know if treating hearing loss could help prevent these problems,” Jennifer A. Deal, co-author and assistant scientist in the Bloomberg School’s Department of Epidemiology, said in the release. “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."

Deal also said poor communication could play a role in the higher costs for patients with hearing loss, noting that they may have trouble communicating their symptoms or hearing what their provider is saying about their care. One solution, she said, is increased access to "amplification devices," which the release notes will become more readily available in 2020, when a federal law authorizing certain types of over-the-counter hearing aids will go into effect.

The study was done in collaboration with AARP, the University of California San Francisco, and OptumLabs.

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