Healthcare utilization and costs are higher in those with untreated hearing loss compared with in individuals without hearing loss, according to the results of an observational study published in JAMA Otolaryngology-Head & Neck Surgery.

Nicholas S. Reed, AuD, of the Otolaryngology-Head and Neck Surgery department at the Johns Hopkins School of Medicine in Baltimore, Maryland, and OptumLabs in Cambridge, Massachusetts, and colleagues used de-identified OptumLabs administrative claims data from more than 3 million individuals who made a claim between January 1, 2000, and December 31, 2016. Costs were adjusted to 2015 US dollars using the medical care component of the Consumer Price Index.

The investigators identified 77,130 individuals with untreated hearing loss and 3,251,863 potential participants without hearing loss. More than 200,000 individuals with and without hearing loss were ultimately included in the study: 154,414 people with 2 years of follow-up data, 44,852 people with 5 years of follow-up data, and 4728 people with 10 years of follow-up data.

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The investigators found that untreated hearing loss was associated with higher healthcare costs in all 3 groups, regardless of length of follow-up. The mean differences were $3852, $11,147, and $22,434 in higher total healthcare costs for those with untreated hearing loss at 2-, 5-, 10-year follow-up, respectively, compared with costs for those without hearing loss. Costs related to hearing loss were a minor component of total healthcare costs. Those with untreated hearing loss were also more likely to experience inpatient hospital stays (incidence rate ratio 1.47) and to be at greater risk for 30-day hospital readmission (relative risk 1.44).

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The authors suggest that the effect of hearing loss on cognitive, physical, and psychosocial functioning may in part explain the increased costs. They note a number of study limitations, including those inherent to using claims data, such as the reliance on coding processes. The lack of Medicaid and uninsured participants also may limit the generalizability of these findings. The authors call for greater awareness of the burden of hearing loss as a public health concern.


Reed NS, Altan A, Deal JA, et al. Trends in health care costs and utilization associated with untreated hearing loss over 10 years [published online November 8, 2018]. JAMA Otolaryngol Head Neck Surg. doi:10.1001/jamaoto.2018.2875