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Review
. 2021 Dec 9;42(4):311-320.
doi: 10.1055/s-0041-1739281. eCollection 2021 Nov.

Barriers to Adult Cochlear Implant Care in the United States: An Analysis of Health Care Delivery

Ashley M Nassiri  1 , John P Marinelli  2 , Donna L Sorkin  3 , Matthew L Carlson  1   4
Affiliations
Review

Barriers to Adult Cochlear Implant Care in the United States: An Analysis of Health Care Delivery

Ashley M Nassiri et al. Semin Hear. .

Abstract

Persistent underutilization of cochlear implants (CIs) in the United States is in part a reflection of a lack of hearing health knowledge and the complexities of care delivery in the treatment of sensorineural hearing loss. An evaluation of the patient experience through the CI health care delivery process systematically exposes barriers that must be overcome to undergo treatment for moderate-to-severe hearing loss. This review analyzes patient-facing obstacles including diagnosis of hearing loss, CI candidate identification and referral to surgeon, CI evaluation and candidacy criteria interpretation, and lastly CI surgery and rehabilitation. Pervasive throughout the process are several themes which demand attention in addressing inequities in hearing health disparities in the United States.

Keywords: barriers to care; cochlear implant; health disparities; hearing loss; patient experience.

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Conflict of interest statement

CONFLICTS OF INTEREST A.M.N.: Research funding from Cochlear Americas. M.L.C.: Research funding from Cochlear Americas.

Figures

Figure 1
Figure 1
Cochlear implant process map. This process map outlines one simplified variation of the steps necessary to undergo cochlear implantation for a candidate patient who self-identifies hearing loss. Solid boxes represent an appointment, and dashed boxes represent events that need to occur prior to the next appointment. In this typical example, the patient must attend 15 appointments from initial diagnosis of hearing loss to completion of 1 year of postoperative programming. HL, hearing loss; PCP, primary care physician; SNHL, sensorineural hearing loss; HA, hearing aid; CI, cochlear implant; MRI, magnetic resonance imaging.
See this image and copyright information in PMC

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