Sorkin Donna L, Buchman Craig A
*American Cochlear Implant Alliance, McLean, Virginia †Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A.
Otol Neurotol. 2016 Feb;37(2):e161-4. doi: 10.1097/MAO.0000000000000946.
Access to cochlear implantation varies greatly around the world. It is affected by factors that are specific to each country's health care system, by awareness, and by societal attitudes regarding deafness.
Cochlear implant clinicians and researchers from six countries explored and discussed these variations and their likely causes: Robert Briggs from Australia; Wolfe-Dieter Baumgartner from Austria; Thomas Lenarz from Germany; Eva Koltharp from Sweden; Christopher Raine from the United Kingdom, and Craig Buchman, Donna Sorkin, and Christine Yoshinago from the United States.
Utilization rates are quite different for the pediatric and adult demographics in all six countries. Pediatric utilization ranges in the six countries (all in the developed world) ranged from a low of 50% in the United States to a high of 97% in Australia. Adult utilization is less than 10% everywhere in the world.
Pediatric access to care was excellent for children with the exception of Germany and the United States where there is an inadequate referral system. Adult utilization was low everywhere because of the lack of screening for adults and the fact that primary care physicians and even audiologists are unfamiliar with CI candidacy criteria and outcomes, and hence typically do not make patient referrals.
世界各地人工耳蜗植入的可及性差异很大。它受到每个国家医疗保健系统特有的因素、认知度以及社会对耳聋态度的影响。
来自六个国家的人工耳蜗临床医生和研究人员探讨并讨论了这些差异及其可能的原因：来自澳大利亚的罗伯特·布里格斯；来自奥地利的沃尔夫 - 迪特尔·鲍姆加特纳；来自德国的托马斯·莱纳尔茨；来自瑞典的伊娃·科尔萨普；来自英国的克里斯托弗·雷恩；以及来自美国的克雷格·布赫曼、唐娜·索尔金和克里斯汀·吉纳戈。
在所有六个国家，儿童和成人人群的使用率差异很大。这六个国家（均为发达国家）的儿童使用率从美国的低至50%到澳大利亚的高至97%不等。全球各地成人的使用率均低于10%。
除了德国和美国转诊系统不完善外，儿童获得治疗的情况良好。各地成人使用率都很低，原因是缺乏对成人的筛查，而且初级保健医生甚至听力学家都不熟悉人工耳蜗植入的候选标准和效果，因此通常不会转诊患者。
