Middle-Age Hearing Loss Results in 33% Higher Healthcare Costs

By John Henry Dreyfuss, MDalert.com staff.

Save to PDF OtolaryngologyEvidence-Based MedicinePerformance-Based Medicine By
  • Individuals diagnosed with hearing loss had 33% higher healthcare payments.
  • Middle-aged individuals with hearing loss expended $14,165 per year in healthcare expenditures versus $10,629 for those with normal hearing over a 1.5-year period.
  • The onset of hearing loss has been found to be gradual, with prevalence tripling from the age of 50 years to 60 years.
  • Age-related hearing loss affects more than 60% of U.S. adults aged ≥70; has been linked to increased risk of hospitalization, decreased quality of life, and increased risk of functional and cognitive decline.
  • This cohort study included 561,764 individuals.

Middle-aged individuals diagnosed with hearing loss (Figure 1) expended 33% more in healthcare payments during a 1.5-year time period compared to patients without hearing loss, according to results of a large trial published recently in JAMA Otolaryngology-Head & Neck Surgery. Hearing loss was found to occur earlier in life than previously recognized and was associated with a broad spectrum of comorbidities. The trial included a total of 561,764 individuals.

 

Figure 1. International epidemiology of late onset hearing loss.

 Age-related hearing loss has been identified in >60% of U.S adults aged ≥70 years, it has been associated with increased risk of hospitalization, decreased quality of life, and increased risk of functional and cognitive decline. The researchers found that over 18 months, individuals with hearing loss expended $14,165, on average, versus $10,629, versus those without hearing loss.

The onset of hearing loss has is generally gradual. The prevalence triples between the ages of 50 to 60 years. In this trial, the authors compared healthcare expenditures for a matched cohort of privately insured individuals with and without a diagnosis of hearing loss. (Figure 2.)

Figure 2. Anatomy of the ear.
This finding indicates that negative health-related effects of hearing loss manifest earlier than is generally recognized and increase the use of healthcare resources across the entire healthcare spectrum. “Studies are needed to identify the underlying factors that lead to the observed cost differences, as well as to ascertain the extent to which early and successful use of hearing aids and other hearing loss interventions modify cost differences,” the authors explained. “Nevertheless, our study suggests that hearing loss is costly, even in middle-aged individuals, and is present in large numbers of adults for whom early, successful intervention may prevent future hearing-related disabilities and decreased quality of life.”

 

Figure 3. Hearing protection has been shown to be effective
for musicians, firearms users, construction workers, concert goers,
and others routinely exposed to high sound pressure volumes.

The Analysis

“Using the Truven Health MarketScan database from January 1, 2009 to December 31 2013, of privately insured individuals with at least 18 months of coverage, we extracted data on a cohort of patients aged 55 to 64 years with an International of Classification of Diseases, Ninth Revision, code for hearing loss (codes V41.2, V72.1x, 388.00, 388.01, 388.40, 388.43, 388.44, 388.5, and 389.2x),” the authors explained. “We then propensity score matched them with a comparison group based on age, sex, US region, insurance type, beneficiary status, Charlson comorbidity score, use of outpatient services, and base line presence of 22 chronic conditions.”

  • Asthma;
  • Carditis;
  • Chronic obstructive pulmonary disease;
  • Chronic renal failure;
  • Conductive heart disease;
  • Congestive heart failure;
  • Cystic fibrosis;
  • Diabetes mellitus type 2;
  • Diverticulitis;
  • Epilepsy;
  • Heart valve disease;
  • Hepatitis;
  • Human immunodeficiency virus;
  • Hypertension;
  • Multiple sclerosis;
  • Parkinson disease;
  • Pulmonary heart disease;
  • Rheumatoid arthritis;
  • Schizophrenia systemic lupus;
  • Senile dementia, and;
  • Sickle cell disease.

In general, the costs of all of these diseases and co-morbidities were found to be compounded and increased by co-morbid hearing loss. (Figures 4 and 5.)

 

Figure 4. Hearing aids have been shown to be effective treatment
of hearing impairment and associated co-morbidities in middle-aged individuals.

Results

Age-related hearing loss affects more than 60% of US adults older than 70 years and has been associated with increased risk of hospitalization, decreased quality of life, and increased risk of functional and cognitive decline. The onset of hearing loss is gradual, with prevalence tripling from the age of 50 years to 60 years.3 However, the association between hearing loss in older middle-aged adults (aged 55-64 years) and the use of health care has not been studied. We compared the costs of health care for a matched cohort of privately insured individuals with and without a diagnosis of hearing loss.

This study uses data from the Truven Health MarketScan database to compare the costs of health care for a matched cohort of privately insured, middle-aged individuals with and without a diagnosis of hearing loss. The researchers included data of privately insured individuals aged 55 to 64 with a diagnosis coding for hearing loss and matched them with a comparison group. Healthcare bills for up to 18 months of follow-up after baseline were summed by patients to calculate total payments for inpatient services, outpatient services, prescription medication, and cost of hearing services.

 This finding indicates that negative health-related effects of hearing loss
manifest earlier than is generally recognized and increase the use of
healthcare resources across the entire healthcare spectrum.

 

Figure 5. Cochlear implants can restore hearing
in middle-aged adults with server hearing impairment.

The Analysis

More than 60% of U.S. adults over the age of 70 have age-related hearing loss, and the rate of hearing loss triples between the ages of 50 and 60, the researchers said. The onset is generally gradually gradual, with prevalence tripling from the age of 50 years to 60 years. However, the association between hearing loss in older middle-aged adults (aged 55-64 years) and the use of health was found to be directly correlated.

For this study, the researchers included data on privately insured individuals 55 to 64 years of age with a diagnosis coding for hearing loss and matched them with a comparison group. Health care bills for up to 18 months of follow-up after baseline were summed by patient to calculate total payments for inpatient services, outpatient services, prescription medication, and cost of hearing services. A total of 561,764 individuals were included in the study.

The researchers compared the costs of healthcare matched with a group of privately insured individuals with and without a diagnosis of hearing loss. The research team, headed by Annie N. Simpson, PhD, Assistant Professor Department of Healthcare Leadership & Management at the Medical University of South Carolina, in Charleston. The study showed an association between hearing loss and higher medical costs. The study was not designed to establish a cause-and-effect relationship.

"This finding indicates that negative health-related effects of hearing loss, a condition that many consider simply an unavoidable result of aging, may manifest earlier than is generally recognized and may affect use of health care across the continuum of care," study author Annie Simpson said in a in JAMA Otolaryngology-Head & Neck Surgery news release. She is an assistant professor in the department of healthcare leadership and management at the Medical University of South Carolina, in Charleston.

"Our study suggests that hearing loss is costly, even in middle-aged individuals, and is present in large numbers of adults for whom early, successful intervention may prevent future hearing-related disabilities and decreased quality of life," the researchers concluded.


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