Departamento de Fonoaudiología, Escuela de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Faculty of Rehabilitation Sciences, School of Speech Therapy, Exercise and Rehabilitation Sciences Institute, Universidad Andres Bello, Santiago, Chile.
Front Public Health. 2024 May 30;12:1364000. doi: 10.3389/fpubh.2024.1364000. eCollection 2024.
BACKGROUND: Access to audiology services for older adults residing in sparsely populated regions is often limited compared to those in central urban areas. The geographic accessibility to follow-up care, particularly the influence of distance, may contribute to an increased risk of hearing aid abandonment. OBJECTIVE: To assess the association between the home-to-healthcare-calibration-center distance and hearing aid abandonment among older adults fitted in the Chilean public health system. METHODS: 455 patients who received hearing aids from two public hospitals in two regions were considered. Univariate and multivariate Poisson regression models with robust variance estimation were used to analyze the association between the geographical distance and hearing aid abandonment, accounting for confounding effects. RESULTS: Approximately 18% of the sample abandoned the hearing aid, and around 50% reported using the hearing aid every day. A twofold increase in distance between home and the hearing center yielded a 35% (RR = 1.35; 95% CI: 1.04-1.74; = 0.022) increased risk of hearing aid abandonment. Also, those in the second quintile had a 2.17 times the risk of abandoning the hearing aid compared to the first quintile (up to 2.3 km). Under the assumption that patients reside within the first quintile of distance, a potential reduction of 45% in the incidence of hearing aid abandonment would be observed. The observed risk remained consistent across different statistical models to assess sensitivity. CONCLUSION: A higher distance between the residence and the healthcare center increases hearing aid abandonment risk. The association may be explained by barriers in purchasing supplies required to maintain the device (batteries, cleaning elements, potential repairs, or maintenance).
背景:与中心城市相比,居住在人口稀少地区的老年人获得听力服务的机会往往有限。后续护理的地理可达性,特别是距离的影响,可能导致助听器的弃用风险增加。
目的:评估老年人在智利公共卫生系统中接受助听器的家庭到医疗校准中心的距离与助听器弃用之间的关联。
方法:考虑了来自两个地区的两家公立医院的 455 名接受助听器的患者。使用具有稳健方差估计的单变量和多变量泊松回归模型来分析地理距离与助听器弃用之间的关联,同时考虑混杂效应。
结果:大约 18%的样本放弃了助听器,大约 50%的人报告每天使用助听器。家庭和听力中心之间的距离增加两倍,导致助听器弃用的风险增加 35%(RR=1.35;95%CI:1.04-1.74;=0.022)。此外,与第一五分位相比,第二五分位的患者放弃助听器的风险高 2.17 倍(距离达到 2.3 公里)。假设患者居住在距离五分位的第一分位内,助听器弃用的发生率可能会降低 45%。观察到的风险在评估敏感性的不同统计模型中保持一致。
结论:居住地与医疗中心之间的距离增加会增加助听器弃用的风险。这种关联可能可以用维持设备(电池、清洁元件、潜在维修或维护)所需的供应品购买障碍来解释。
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