Okuba Tolesa, Lystad Reidar P, Boisvert Isabelle, McMaugh Anne, Moore Robyn Cantle, Wolnizer Peter, Chow Cassidy, Walsan Ramya, Mitchell Rebecca J
Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
BMC Public Health. 2025 May 8;25(1):1695. doi: 10.1186/s12889-025-22898-8.
Data about the ongoing health service use, health outcomes and healthcare treatment costs of adult cochlear implant users are limited. This study examined health service use, health outcomes and treatment costs of adults who had a cochlear implant.
This was a retrospective cohort study of adults aged ≥ 18 years who received a cochlear implant during 2011-2021. Linked hospitalisation, non-admitted patient (NAP) services and mortality data in New South Wales (NSW), Australia were used. Health service use, health outcomes and treatment costs were compared for younger (18-64 years) and older (≥ 65 years) adults. A negative binomial regression model was used to examine factors associated with hospitalisation and health outcomes.
There were 3071 adults who had a cochlear implant; 47.6% aged 18-64 years and 52.4% aged ≥ 65 years. Older adults had a higher proportion of all-cause hospital admissions (34.1% vs. 18.4%, respectively), readmission within 28 days (7.8% vs. 4.7%, respectively), ≥ 13 NAP service contacts (33.9% vs. 24.9%, respectively) and mean treatment costs (AUD$44,101 vs. AUD$41,663, respectively) than younger adults. Charlson comorbidities and mental health disorders were key predictors of both hospitalisations and NAP service contacts for younger adults. Postoperative mechanical complications and prior hospital admissions were predictors of hospitalisation and NAP service contacts, respectively for younger adults. Having ≥13 NAP service contacts and a cochlear implant removed were predictors of hospitalisation and NAP service contacts, respectively for older adults. Having a longer hospital length of stay (LOS) was associated with cochlear implant removal, treatment cost, and other health conditions for both younger and older adults.
Adults with multimorbidity used more hospital-based services or incurred large treatment costs. Early detection and treatment of comorbidities and long-term post-cochlear implant follow-up to identify any potential complications may reduce unplanned hospitalisations, adverse health outcomes, and associated hospital utilisation costs.
关于成年人工耳蜗使用者当前的医疗服务使用情况、健康结局和医疗费用的数据有限。本研究调查了接受人工耳蜗植入的成年人的医疗服务使用情况、健康结局和治疗费用。
这是一项对2011年至2021年期间接受人工耳蜗植入的≥18岁成年人的回顾性队列研究。使用了澳大利亚新南威尔士州（NSW）的相关住院、非住院患者（NAP）服务和死亡率数据。比较了年轻（18 - 64岁）和年长（≥65岁）成年人的医疗服务使用情况、健康结局和治疗费用。采用负二项回归模型来研究与住院和健康结局相关的因素。
共有3071名成年人接受了人工耳蜗植入；其中47.6%年龄在18 - 64岁，52.4%年龄≥65岁。年长成年人的全因住院比例更高（分别为34.1%和18.4%）、28天内再入院比例更高（分别为7.8%和4.7%）、≥13次NAP服务接触比例更高（分别为33.9%和24.9%）以及平均治疗费用更高（分别为44,101澳元和41,663澳元）。Charlson合并症和心理健康障碍是年轻成年人住院和NAP服务接触的关键预测因素。术后机械并发症和既往住院史分别是年轻成年人住院和NAP服务接触的预测因素。≥13次NAP服务接触和人工耳蜗移除分别是年长成年人住院和NAP服务接触的预测因素。住院时间较长与年轻和年长成年人的人工耳蜗移除、治疗费用及其他健康状况相关。
患有多种疾病的成年人使用了更多基于医院的服务或产生了高额治疗费用。对合并症进行早期检测和治疗以及人工耳蜗植入后的长期随访以识别任何潜在并发症，可能会减少计划外住院、不良健康结局及相关的医院利用成本。
