成年人工耳蜗植入候选者和接受者获得听力保健服务的情况:出行时间和社会经济地位。

Hearing health care access for adult cochlear implant candidates and recipients: Travel time and socioeconomic status.

作者信息

Davis Amanda G, Hicks Kelli L, Dillon Margaret T, Overton Andrea B, Roth Noelle, Richter Margaret E, Dedmon Matthew M

机构信息

Division of Speech and Hearing Sciences, Department of Allied Health Sciences University of North Carolina at Chapel Hill Chapel Hill North Carolina USA.

Department of Otolaryngology/Head & Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina USA.

出版信息

Laryngoscope Investig Otolaryngol. 2023 Jan 17;8(1):296-302. doi: 10.1002/lio2.1010. eCollection 2023 Feb.

Abstract

OBJECTIVES

Access to cochlear implantation may be negatively influenced by extended travel time to a cochlear implant (CI) center or lower socioeconomic status (SES) for the individual. There is a critical need to understand the influence of these variables on patient appointment attendance for candidacy evaluations, and CI recipients' adherence to post-activation follow-up recommendations that support optimal outcomes.

METHODS

A retrospective chart review of adult patients referred to a CI center in North Carolina for initial cochlear implantation candidacy evaluation between April 2017 and July 2019 was conducted. Demographic and audiologic data were collected for each patient. Travel time was determined using geocoding. SES was proxied using ZCTA-level Social Deprivation Index (SDI) information. Independent samples tests compared variables between those who did and did not attend the candidacy evaluation. Pearson correlations assessed the association of these variables and the duration of time between initial CI activation and return for first follow-up visit.

RESULTS

Three hundred and ninety patients met the inclusion criteria. There was a statistically significant difference between SDI of those who attended their candidacy evaluation versus those who did not. Age at referral or travel time did not show statistical significance between these two groups. There was no significant correlation with age at referral, travel time, or SDI with the duration of time (days) between initial activation and the 1-month follow-up.

CONCLUSIONS

Our findings suggest that SES may influence a patient's ability to attend a cochlear implantation candidacy evaluation appointment and may further impact the decision to pursue cochlear implantation.Level of evidence: 4 - Case Series.

摘要

目的

前往人工耳蜗(CI)中心的行程时间延长或个人社会经济地位(SES)较低可能会对人工耳蜗植入的可及性产生负面影响。迫切需要了解这些变量对患者参加候选资格评估预约的影响,以及CI接受者对支持最佳效果的激活后随访建议的依从性。

方法

对2017年4月至2019年7月期间转诊至北卡罗来纳州一家CI中心进行初次人工耳蜗植入候选资格评估的成年患者进行回顾性病历审查。收集每位患者的人口统计学和听力学数据。使用地理编码确定行程时间。SES使用邮政编码级别社会剥夺指数(SDI)信息进行代理。独立样本检验比较了参加和未参加候选资格评估的患者之间的变量。Pearson相关性评估了这些变量与初次CI激活至首次随访复诊之间的时间间隔的关联。

结果

390名患者符合纳入标准。参加候选资格评估的患者与未参加的患者的SDI之间存在统计学显著差异。转诊时的年龄或行程时间在这两组之间未显示出统计学显著性。转诊时的年龄、行程时间或SDI与初次激活至1个月随访之间的时间间隔(天数)无显著相关性。

结论

我们的研究结果表明,SES可能会影响患者参加人工耳蜗植入候选资格评估预约的能力,并可能进一步影响进行人工耳蜗植入的决定。证据级别:4 - 病例系列。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbcd/9948562/f1d9b81fb28d/LIO2-8-296-g003.jpg

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