Association between the home-to-healthcare center distance and hearing aid abandonment among older adults

Abstract

Background: Access to audiology services for older adults residing in sparsely populated regions is often limited compared to those in central urban areas. The geographic accessibility to follow-up care, particularly the influence of distance, may contribute to an increased risk of hearing aid abandonment.

Objective: To assess the association between the home-to-healthcare-calibration-center distance and hearing aid abandonment among older adults fitted in the Chilean public health system.

Methods: 455 patients who received hearing aids from two public hospitals in two regions were considered. Univariate and multivariate Poisson regression models with robust variance estimation were used to analyze the association between the geographical distance and hearing aid abandonment, accounting for confounding effects.

Results: Approximately 18% of the sample abandoned the hearing aid, and around 50% reported using the hearing aid every day. A twofold increase in distance between home and the hearing center yielded a 35% (RR = 1.35; 95% CI: 1.04-1.74; p = 0.022) increased risk of hearing aid abandonment. Also, those in the second quintile had a 2.17 times the risk of abandoning the hearing aid compared to the first quintile (up to 2.3 km). Under the assumption that patients reside within the first quintile of distance, a potential reduction of 45% in the incidence of hearing aid abandonment would be observed. The observed risk remained consistent across different statistical models to assess sensitivity.

Conclusion: A higher distance between the residence and the healthcare center increases hearing aid abandonment risk. The association may be explained by barriers in purchasing supplies required to maintain the device (batteries, cleaning elements, potential repairs, or maintenance).

Keywords: age-related hearing loss; follow-up care; geographic accessibility; hearing aid abandonment; hearing aids.

Figure 1

Distances from the patient’s homes to the follow-up healthcare centers in the Metropolitan region are described as heat map. Dark red shades indicate the shortest distances, while lighter shades of yellow represent great distances. The blue circle on the map represents the healthcare center’s location, and the “x” symbol denotes the patient’s home.

Figure 2

Distances from the patient’s homes to the follow-up healthcare centers in the Valparaiso region are described as heat map. Dark red shades indicate the shortest distances, while lighter shades of yellow represent great distances. The blue circle on the map represents the healthcare center’s location, and the “x” symbol denotes the patient’s home.