Ostevik Amberley V, Westover Lindsey, Gynane Haley, Herst Jordan, Cummine Jacqueline, Hodgetts William E
Registered Audiologist, Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB.
Assistant Professor, Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine and Department of Mechanical Engineering, Institute for Reconstructive Sciences in Medicine, University of Alberta, Edmonton, AB.
Healthc Policy. 2019 Nov;15(2):72-84. doi: 10.12927/hcpol.2019.26070.
Of the several barriers associated with uptake and adherence to hearing services, cost is the most commonly identified barrier in Canada. This study evaluated health insurance plans for hearing care coverage within Alberta, Canada, and subsequent out-of-pocket expenses that would result if an individual chose to pursue treatment.
An investigation of eight companies that provide supplementary health coverage in Alberta was conducted. Categories of health service coverage included hearing, vision, speech-language pathology (S-LP), physical therapy related (PT-R; including massage therapy and chiropractic therapy) and alternative medicine related (AM-R; including osteopathy, acupuncture and naturopathy). All coverage amounts were corrected to a four-year term for comparison purposes.
For a four-year term, the coverage amounts for hearing services were CAD 300-750; for vision services were CAD 0-900; for S-LP services were CAD 0-2,400; for PT-R services were CAD 1,400-10,200; and for AM-R services were CAD 0-10,200 per four-year term. The expected out-of-pocket expense for vision ranged from CAD 0 to CAD 2,766, whereas for hearing, it ranged from CAD 250 to CAD 11,700.
A considerable range and discrepancy were reported between hearing care and most paramedical services. In addition, the coverage amounts for hearing care were inconsistent with treatment costs, resulting in considerable out-of-pocket expenses for most consumers. The potential implications of such cost-related barriers on public health are an important consideration as our understanding of the impact of untreated hearing impairment continues to increase.
在与听力服务的接受和依从性相关的若干障碍中，费用是加拿大最常被提及的障碍。本研究评估了加拿大艾伯塔省听力保健覆盖的健康保险计划，以及个人选择寻求治疗时随之产生的自付费用。
对艾伯塔省提供补充健康保险的八家公司进行了调查。健康服务覆盖类别包括听力、视力、言语语言病理学（S-LP）、物理治疗相关（PT-R；包括按摩疗法和脊椎按摩疗法）以及替代医学相关（AM-R；包括整骨疗法、针灸和自然疗法）。为便于比较，所有覆盖金额均换算为四年期。
四年期内，听力服务的覆盖金额为300 - 750加元；视力服务为0 - 900加元；S-LP服务为0 - 2400加元；PT-R服务为1400 - 10200加元；AM-R服务每四年期为0 - 10200加元。视力方面的预期自付费用为0至2766加元，而听力方面则为250至11700加元。
听力保健与大多数辅助医疗服务之间存在相当大的范围和差异。此外，听力保健的覆盖金额与治疗成本不一致，导致大多数消费者需承担相当大的自付费用。随着我们对未经治疗的听力障碍影响的认识不断加深，此类与成本相关的障碍对公共卫生的潜在影响是一个重要的考量因素。
