Estimation of Tinnitus-Related Socioeconomic Costs in Germany

Abstract

Despite the high prevalence of tinnitus in Germany of nearly 12% of the general population, there have been no systematic studies on the socioeconomic costs for German society caused by tinnitus so far. Here we analyzed data from 258 chronic tinnitus patients-namely tinnitus severity and health utility index (HUI)-and correlated them with their tinnitus-related public health care costs, private expenses, and economic loss due to their tinnitus percept as assessed by questionnaires. We found correlations of the HUI with health care costs and calculated the mean socioeconomic costs per tinnitus patient in Germany. According to our most conservative estimate, these sum up to EUR 4798.91 per year. Of that EUR 2206.95 account for the public health care, EUR 290.45 are carried by the patient privately and the remaining EUR 2301.51 account for economical loss due to sick leave. With a prevalence of 5.5% with at least bothersome tinnitus, this sums up to 21.9 billion Euro per year and with 25.82 sick leave days; tinnitus patients miss work more than double the time of the average German employee (10.9 days). The findings fit within the cost ranges of studies from other European countries and the USA and show that the socioeconomic burden of this disease-like symptom is a global problem. In comparison with the costs of other major chronic diseases in Germany-such as chronic obstructive pulmonary diseases (ca. 16 billion Euro) or diabetes mellitus (ca. 42 billion Euro)-the relevance of the 'symptom' tinnitus for the German social economy becomes even more obvious.

Keywords: health utility index; hearing loss; socioeconomic costs; tinnitus; tinnitus questionnaire.

Figure 1

Relationship of HL, tinnitus severity index and HUI score. (A) Results of the two-factorial ANOVA of the patients’ binaural HL dependent on the factors ‘frequency’ and ‘tinnitus severity’. Given is the interaction plot of both factors with the F-statistics. The inset depicts the effect of the factor tinnitus severity (averaged over all frequencies). Note that all groups are significantly different from each other (Tukey post-hoc tests). (B) Significant multiple linear regression analysis of the individual mean binaural HL (averaged over all frequencies) and the tinnitus severity index. (C) Significant linear regression analysis of the individual HUI score and the tinnitus severity index. (D) Significant linear regression analysis of the individual HUI score and the mean binaural HL.

Figure 2

Multiple linear regression analyses of overall and healthcare costs with tinnitus severity index and HUI score/sub-scores. (A) No significant regression for the individual overall costs and the tinnitus severity index. Severity index color scheme as in Figure 1. (B) No significant regression (grey line) for the overall costs and the HUI score. (C) Significant linear regression (red line) for the healthcare costs and the HUI score. (D) Significant linear regressions (red lines) for the healthcare costs and the HUI sub-scores tinnitus penetrance, sleep impairment, and somatic disorders.