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老年医疗保险受益人中自我报告的听力损失与失去常规医疗保健来源之间的关联:来自国家健康与老龄化趋势研究的证据。

The Association Between Self-Reported Hearing Loss and Loss of Usual Source of Health Care Among Older Medicare Beneficiaries: Evidence From the National Health and Aging Trends Study.

作者信息

Garcia Morales Emmanuel, Assi Lama, Powell Danielle, Luu Kayti, Reed Nicholas

机构信息

Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Department of Ophthalmology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.

出版信息

Innov Aging. 2023 Jan 16;7(1):igad002. doi: 10.1093/geroni/igad002. eCollection 2023.

Abstract

BACKGROUND AND OBJECTIVES

The purpose of the study is to investigate the association of hearing loss (HL) with maintaining a usual source of care (USOC).

RESEARCH DESIGN AND METHODS

In this study we implemented a time-to-event analysis using data from the National Health and Aging Trends Study (NHATS), a nationally representative study of older Medicare beneficiaries in the United States. The study sample included 2 114 older adults, aged 65+ years, 58.9% female, 20.4% Black, who reported having a USOC during the baseline round of NHATS and who remained community-dwelling during the 2011-2018 study period. Based on self-report measures at baseline, individuals' hearing status was classified into 3 categories: no HL, treated HL (hearing aids users), and untreated HL (nonhearing aid users who reported having hearing difficulties). Time-to-event was computed as the time elapsed between baseline and the study round in which the respondent first reported no longer having a USOC. Discrete-time proportional hazard models were estimated.

RESULTS

In fully adjusted models, untreated HL at baseline was associated with a hazard ratio (HR) for losing one's USOC 1.60 (95% confidence interval: 1.01, 2.56) times higher than that of participants with no HL. We found no HR differences between the treated- and no-HL group.

DISCUSSION AND IMPLICATIONS

Untreated HL at baseline was associated with a higher probability of losing one's USOC over time. Noninvasive interventions such as hearing aids may be beneficial for maintaining a USOC.

摘要

背景与目的

本研究旨在调查听力损失(HL)与维持常规医疗服务来源(USOC)之间的关联。

研究设计与方法

在本研究中,我们使用了来自美国国家健康与老龄化趋势研究(NHATS)的数据进行事件发生时间分析,该研究是一项针对美国老年医疗保险受益人的全国代表性研究。研究样本包括2114名65岁及以上的老年人,其中女性占58.9%,黑人占20.4%,他们在NHATS的基线调查轮次中报告有USOC,并且在2011 - 2018年研究期间一直居住在社区。根据基线时的自我报告测量,个体的听力状况分为3类:无听力损失、已治疗的听力损失(助听器使用者)和未治疗的听力损失(报告有听力困难的非助听器使用者)。事件发生时间计算为基线与受访者首次报告不再有USOC的研究轮次之间经过的时间。估计了离散时间比例风险模型。

结果

在完全调整的模型中,基线时未治疗的听力损失与失去USOC的风险比(HR)为1.60(95%置信区间:1.01,2.56),高于无听力损失的参与者。我们发现已治疗的听力损失组和无听力损失组之间的HR没有差异。

讨论与启示

基线时未治疗的听力损失与随着时间推移失去USOC的可能性较高相关。诸如助听器等非侵入性干预措施可能有助于维持USOC。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d039/9999675/13c87a728a0b/igad002_fig1.jpg

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