Health Services Research & Development Center of Excellence, VA Puget Sound Health Care System, 1100 Olive Way, Suite 1400, Seattle, WA 98101, USA.
BMC Health Serv Res. 2009 Dec 15;9:233. doi: 10.1186/1472-6963-9-233.
Hearing impairment is the most common body system disability in veterans. In 2008, nearly 520,000 veterans had a disability for hearing loss through the Department of Veterans Affairs (VA). Changes in eligibility for hearing aid services, along with the aging population, contributed to a greater than 300% increase in the number of hearing aids dispensed from 1996 to 2006. In 2006, the VA committed to having no wait times for patient visits while providing quality clinically-appropriate care. One approach to achieving this goal is the use of group visits as an alternative to individual visits. We sought to determine: 1) if group hearing aid fitting and follow-up visits were at least as effective as individual visits, and 2) whether group visits lead to cost savings through the six month period after the hearing aid fitting. We describe the rationale, design, and characteristics of the baseline cohort of the first randomized clinical trial to study the impact of group versus individual hearing aid fitting and follow-up visits.
Participants were recruited from the VA Puget Sound Health Care System Audiology Clinic. Eligible patients had no previous hearing aid use and monaural or binaural air-conduction hearing aids were ordered at the evaluation visit. Participants were randomized to receive the hearing aid fitting and the hearing aid follow-up in an individual or group visit. The primary outcomes were hearing-related function, measured with the first module of the Effectiveness of Aural Rehabilitation (Inner EAR), and hearing aid adherence. We tracked the total cost of planned and unplanned audiology visits over the 6-month interval after the hearing aid fitting.
A cohort of 659 participants was randomized to receive group or individual hearing aid fitting and follow-up visits. Baseline demographic and self-reported health status and hearing-related measures were evenly distributed across the treatment arms.Outcomes after the 6-month follow-up period are needed to determine if group visits were as least as good as those for individual visits and will be reported in subsequent publication.
NCT00260663.
听力损伤是退伍军人中最常见的身体系统残疾。2008 年，通过退伍军人事务部（VA），有近 52 万名退伍军人因听力损失而残疾。由于获得助听器服务的资格发生了变化，加上人口老龄化，1996 年至 2006 年期间，发放的助听器数量增加了 300%以上。2006 年，VA 承诺在提供高质量临床适宜护理的同时，为患者就诊提供无等待时间。实现这一目标的一种方法是使用小组就诊作为替代个体就诊。我们试图确定：1）小组助听器适配和随访就诊是否至少与个体就诊一样有效，以及 2）小组就诊是否通过助听器适配后的六个月期间节省成本。我们描述了首次随机临床试验的基本原理、设计和基线队列特征，该试验旨在研究小组与个体助听器适配和随访就诊的影响。
参与者从 VA 普吉特湾医疗保健系统听力诊所招募。符合条件的患者以前没有使用过助听器，并且在评估就诊时订购了单耳或双耳空气传导助听器。参与者随机分配到个体或小组就诊接受助听器适配和助听器随访。主要结果是听力相关功能，使用听觉康复效果的第一个模块（内耳）进行测量，以及助听器的适应性。我们跟踪了助听器适配后 6 个月内计划和非计划听力学就诊的总费用。
共有 659 名参与者被随机分配到接受小组或个体助听器适配和随访就诊。治疗组的基线人口统计学和自我报告的健康状况和听力相关测量值分布均匀。需要在 6 个月的随访期后确定小组就诊是否与个体就诊一样好，结果将在随后的出版物中报告。
NCT00260663。
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