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在全国健康访谈调查中听力损失、助听器和对医疗保健的满意度。

Hearing Loss, Hearing Aids, and Satisfaction With Health Care in the National Health Interview Survey.

机构信息

College of Public Health, University of South Florida, Tampa, Florida, USA.

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

出版信息

Otolaryngol Head Neck Surg. 2024 Feb;170(2):414-421. doi: 10.1002/ohn.533. Epub 2023 Sep 25.

Abstract

OBJECTIVE

Hearing loss may negatively impact satisfaction with health care via patient-provider communication barriers and may be amenable to hearing care treatment.

STUDY DESIGN

Cross-sectional.

SETTING

National Health Interview Survey, a nationally representative survey of noninstitutionalized US residents, 2013 to 2018 pooled cycles.

METHODS

Participants described satisfaction with health care in the past year, categorized as optimal (very satisfied) versus suboptimal (satisfied, dissatisfied, very dissatisfied) satisfaction. Self-report hearing without hearing aids (excellent, good, a little trouble, moderate trouble, a lot of trouble) and hearing aid use (yes, no) were collected. Weighted Poisson regression models adjusted for sociodemographic and health covariates were used to estimate prevalence rate ratios (PRRs) of satisfaction with care by hearing loss and hearing aid use.

RESULTS

Among 137,216 participants (mean age 50.9 years, 56% female, 12% black), representing 77.2 million Americans in the weighted model, 19% reported trouble hearing. Those with good (PRR = 1.20, 95% confidence interval [CI]: 1.18-1.23), a little trouble (PRR = 1.27, 95% CI, 1.23-1.31), moderate trouble (PRR = 1.29, 95% CI, 1.24-1.35), and a lot of trouble hearing (PRR = 1.26, 95% CI, 1.18-1.33) had a higher prevalence rate of suboptimal satisfaction with care relative to those with excellent hearing. Among all participants with trouble hearing, hearing aid users had a 17% decrease in the prevalence rate of suboptimal satisfaction with care (PRR = 0.83, 95% CI, 0.78-0.88) compared to nonusers.

CONCLUSION

Hearing loss decreases patient satisfaction with health care, which is tied to Medicare hospital reimbursement models. Hearing aid use may improve patient-provider communication and patient satisfaction, although prospective studies are warranted to truly establish their protective effect.

摘要

目的

听力损失可能会通过医患沟通障碍对患者的医疗保健满意度产生负面影响,并且可能适合听力保健治疗。

研究设计

横断面研究。

地点

全国健康访谈调查(National Health Interview Survey),这是对美国非机构化居民进行的全国代表性调查,在 2013 年至 2018 年的多个周期中进行了汇总。

方法

参与者描述了过去一年对医疗保健的满意度,分为最优(非常满意)和次优(满意、不满意、非常不满意)。收集了无助听器(优秀、良好、有一点困难、中度困难、严重困难)和助听器使用(是、否)的自我报告听力情况。使用加权泊松回归模型,根据社会人口统计学和健康协变量进行调整,以估计听力损失和助听器使用对医疗保健满意度的患病率比(PRR)。

结果

在 137216 名参与者(平均年龄为 50.9 岁,56%为女性,12%为黑人)中,加权模型中代表了 7720 万美国人,有 19%的人表示听力有困难。那些听力良好(PRR=1.20,95%置信区间[CI]:1.18-1.23)、有一点困难(PRR=1.27,95%CI,1.23-1.31)、中度困难(PRR=1.29,95%CI,1.24-1.35)和严重困难(PRR=1.26,95%CI,1.18-1.33)的人,与听力优秀的人相比,对医疗保健的满意度较低。在所有有听力问题的参与者中,与非使用者相比,助听器使用者对次优医疗保健满意度的患病率降低了 17%(PRR=0.83,95%CI,0.78-0.88)。

结论

听力损失会降低患者对医疗保健的满意度,这与医疗保险医院报销模式有关。助听器的使用可能会改善医患沟通和患者满意度,尽管需要前瞻性研究来真正确定其保护作用。

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