Short Article

Clinical Characteristics and Hearing Aid Uptake Rate of Patients Seen at the Community Hearing Clinic: A Model of Upstream Preventive Care and Earlier Intervention

Abstract

Background and Aim: Presbyacusis is one of the most common causes of hearing loss for seniors age above 60 years. Yet diagnostic hearing tests are not readily accessible to seniors in the community. Since 2018, the Ministry of Health in Singapore started a pilot program to screen them for their visual, oral, and hearing health in the community and improve accessibility to hearing healthcare. We describe the clinical characteristics of seniors presenting to Community Hearing Clinic (CHC) and compared hearing aid uptake rates with patients seen at a tertiary hospital.
Methods: Retrospective cross-sectional descriptive study on Singaporeans with hearing difficulties presenting to the community clinics.
Results: Attendance rates were generally positive at more than 80% and is comparable to the specialist outpatient clinic at the tertiary hospital. Hearing aid uptake rates were comparable between CHC and tertiary hospital at 61.9% and 66.9% respectively. Despite having better accessibility with direct access to the audiologists, and more financial subsidies, the eventual uptake rates of hearing aids are not clinically different at the CHC.
Conclusion: CHC may be a viable model of improving accessibility to hearing healthcare with audiologists providing the 1st level of triaging safely. However, the cost-effectiveness of this model remains to be seen. Further health service research studies are warranted to determine the cost-effectiveness of sandbox CHC. Right-siting and expanding the sandbox to include access to hearing aid subsidies in private clinics may further help with this move beyond hospital to the community in line with our public health vision.

[1] Prime Minister’s Office. National Population and Talent Division. Singapore: Prime Minister’s Office; 2013. Jan, Population White Paper: a sustainable population for a dynamic Singapore [Internet] [cited 2023 May 27]. Available from: https://www.
strategygroup.gov.sg/media-centre/population-white-paper-asustainable-population-for-a-dynamic-singapore
[2] Barnett M, Hixon B, Okwiri N, Irungu C, Ayugi J, Thompson R, et al. Factors involved in access and utilization of adult hearing healthcare: A systematic review. Laryngoscope. 2017;127(5):1187-94. [DOI:10.1002/lary.26234]
[3] Iankilevitch M, Singh G, Russo FA. A Scoping Review and Field Guide of Theoretical Approaches and Recommendations to Studying the Decision to Adopt Hearing Aids. Ear Hear. 2023;44(3):460-76. [DOI:10.1097/AUD.0000000000001311]
[4] Ruusuvuori JE, Aaltonen T, Koskela I, Ranta J, Lonka E, Salmenlinna I, et al. Studies on stigma regarding hearing impairment and hearing aid use among adults of working age: a scoping review. Disabil Rehabil. 2021;43(3):436-46. [DOI:10.1080/09638288.2019.1622798]
[5] Bennett RJ, Laplante-Lévesque A, Eikelboom RH. How Do Hearing Aid Owners Respond to Hearing Aid Problems? Ear Hear. 2019;40(1):77-87. [DOI:10.1097/AUD.0000000000000595]
[6] Simpson AN, Matthews LJ, Cassarly C, Dubno JR. Time From Hearing Aid Candidacy to Hearing Aid Adoption: A Longitudinal Cohort Study. Ear Hear. 2019;40(3):468-76. [DOI:10.1097/AUD.0000000000000641]
[7] Shukla A, Harper M, Pedersen E, Goman A, Suen JJ, Price C, et al. Hearing Loss, Loneliness, and Social Isolation: A Systematic Review. Otolaryngol Head Neck Surg. 2020;162(5):622-33. [DOI:10.1177/0194599820910377]
[8] Dixon PR, Feeny D, Tomlinson G, Cushing S, Chen JM, Krahn MD. Health-Related Quality of Life Changes Associated With Hearing Loss. JAMA Otolaryngol Head Neck Surg. 2020;146(7):630-8. [DOI: 10.1001/jamaoto.2020.0674]
[9] Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396(10248):413-46. [DOI:10.1016/S0140-6736(20)30367-6]
[10] Lim ZH, Soo YP, Loo JHY. Clinical profiles of patients referred to an ear, nose and throat specialist clinic via community mobile hearing clinic in Singapore. Proc Singapore Healthc. 2021;30(4):286-93. [DOI:10.1177/2010105820979322]
[11] Chua Wei De K. The Impact of Senior Mobility Funding on Hearing Aid Acquisition and Compliance to Hearing Aid Use in a Singapore Hospital. J Audiol Otol. 2021;25(1):8-13. [DOI:10.7874/jao.2020.00213]
[12] Singapore Ministry of Health. Direct subsidised referral protocol for seniors aged 60 years and above, from community-based screening to ear, nose & throat (ENT) outpatient clinics in public hospitals. MOH Circular No. 53/2018 (MH 53:15/56). Singapore: Ministry of Health, 2018.
[13] Zapala DA, Stamper GC, Shelfer JS, Walker DA, Karatayli-Ozgursoy S, Ozgursoy OB, et al. Safety of audiology direct access for medicare patients complaining of impaired hearing. J Am Acad Audiol. 2010;21(6):365-79. [DOI:10.3766/jaaa.21.6.2]
Files
IssueVol 33 No 1 (2024) QRcode
SectionShort Article(s)
DOI https://doi.org/10.18502/avr.v33i1.14277
Keywords
Community health services audiology hearing aids financing governmental

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Chua KWD, Yuen HW. Clinical Characteristics and Hearing Aid Uptake Rate of Patients Seen at the Community Hearing Clinic: A Model of Upstream Preventive Care and Earlier Intervention. Aud Vestib Res. 2023;33(1):79-84.