Untreated hearing loss can result in higher healthcare costs

One in six Australians are affected by hearing loss and with an ageing population, this condition is expected to increase by 2050. Globally, 360 million people have disabling hearing loss and if left untreated it can lead to a higher risk of dementia and cognitive decline, falls, depression and a lower quality of life, including a rise in morbidity. Untreated hearing loss can also lead to substantial health care costs, according to a new study by researchers at Johns Hopkins Bloomberg School of Public Health.

The researchers analysed healthcare information from the OptumLabs Data Warehouse including administrative claims from 1999 to 2016 for people enrolled in large, private US health plans and Medicare Advantage plans. Using diagnosis codes, the researchers identified more than 77,000 patients with likely age-related untreated hearing loss. The researchers excluded patients whose claims data indicated that the patients used a hearing aid or whose hearing loss was secondary to a medical condition or toxic agent such as chemotherapy. The researchers then matched each of these patients with other patients in the claims database on more than 25 factors including demographic characteristics, baseline health conditions and measures of health care utilisation — inpatient hospitalisations and readmissions within 30 days, emergency department visits, days with at least one outpatient visit and health care costs. The researchers analysed health care cost and utilisation outcomes and trends at two-, five- and 10-year follow-up periods.

Compared to the patients without hearing loss, patients with the condition incurred nearly 26 per cent more in total health care costs within two years.

The researchers found that at the 10-year follow up, patients with untreated hearing loss experienced about 50 per cent more hospital stays and had about a 44 per cent higher risk for hospital readmission within 30 days. They were also 17 per cent more likely to visit the emergency department and had about 52 more outpatient visits compared to those without hearing loss. The differences in costs incurred between the two groups were clear as early as two years after diagnosis. Compared to the patients without hearing loss, patients with the condition incurred nearly 26 per cent more in total health care costs within two years. This gap widened further to 46 per cent by 10 years, amounting to $22,434 per individual — $20,403 incurred by the health plan and $2,030 by the individual in out-of-pocket costs. When the researchers calculated how much of the extra $22,434 in health care costs were likely due solely to hearing loss-related services, the total was only about $600 over 10 years.

The researchers believe that higher healthcare costs incurred by patients with hearing loss is likely related to other serious health issues — verified by a companion study using the same data set. This suggests that compared to those without hearing loss, people with untreated hearing loss have had 3.2 more dementia diagnoses, 3.6 more falls and 6.9 more depression diagnoses per 100 people over 10 years. Another possibility is that hearing loss could impede patient-provider communication which could account for greater health care costs and utilisations as it becomes difficult for patients to understand and follow recommended instructions for their own care.

Source: John Hopkins University