Comparison of Socioeconomic Factors Influencing Delay and Underuse of Cochlear Implants.

IF 2.6 3区医学 Q1 OTORHINOLARYNGOLOGY

Otolaryngology- Head and Neck Surgery Pub Date : 2025-04-10 DOI:10.1002/ohn.1250

Maryann Zhao, Victoria Huang, Michelle H Zhang, Jack Y Ghannam, Mary M Morcos, Jennifer J Shin, Alicia M Quesnel, Carleton E Corrales, James G Naples

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引用次数: 0

Abstract

Objective: To evaluate and compare socioeconomic factors associated with underuse and prolonged time to cochlear implant (CI) surgery for qualifying candidates.

Study design: Retrospective cohort study of adult patients who were CI candidates from January 1, 2018, to December 31, 2022.

Setting: Three tertiary academic centers.

Methods: Demographic factors (age, sex, race, zip code, insurance status, preferred language, and marital status) and speech recognition scores in quiet and distance to CI center were collected. Household income quintiles were determined based on zip code matching to US Census data. Main outcomes were decision to pursue CI surgery and time elapsed from initial candidacy to surgery.

Results: A total of 382 patients were evaluated for CI candidacy and included in the analysis (191 [50%] women; median age, 70 years; interquartile range [IQR] 58-78). Of these, 306 (80%) underwent cochlear implantation. Multivariable analyses revealed that, among those who qualified, patients with non-English-speaking status (odds ratio [OR] 0.31 [95% CI: 0.13-0.71]), older age (OR 0.97 [95% CI: 0.94-0.99]), male sex (OR 0.40 [95% CI: 0.23-0.72]), and higher speech recognition scores (21%-40%: OR 0.33 [95% CI: 0.15-0.70]; >41%: OR 0.24 [95% CI: 0.076-0.74]) were less likely to receive surgery. Among those who underwent surgery, only non-English-speaking patients experienced significantly longer time to surgery relative to English-speaking patients (hazard ratio [HR] 0.64 [95% CI: 0.43-0.97]).

Conclusion: Language is a potential enduring factor impacting both pursuit of and time to CI surgery. Future work should consider target strategies to account for these factors as a way to improve CI access.

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影响人工耳蜗延迟使用和未充分使用的社会经济因素比较。

目的：评估和比较符合条件的人工耳蜗（CI）手术患者未充分使用和延长手术时间的社会经济因素。研究设计：对2018年1月1日至2022年12月31日的CI候选成年患者进行回顾性队列研究。环境：三个高等教育中心。方法：收集人口统计学因素（年龄、性别、种族、邮政编码、保险状况、首选语言、婚姻状况）以及安静和距离CI中心的语音识别评分。家庭收入的五分位数是根据邮政编码与美国人口普查数据的匹配来确定的。主要结果是决定进行CI手术和从最初候选到手术的时间。结果：共有382例患者被评估为CI候选资格并纳入分析(191例[50%]女性；中位年龄70岁；四分位间距[IQR] 58-78)。其中，306例（80%）接受了人工耳蜗植入。多变量分析显示，在符合条件的患者中，非英语状态（比值比[OR] 0.31 [95% CI: 0.13-0.71]）、年龄较大（OR 0.97 [95% CI: 0.94-0.99]）、男性（OR 0.40 [95% CI: 0.23-0.72]）和较高的语音识别评分（21%-40%:OR 0.33 [95% CI: 0.15-0.70]）；41%: OR 0.24 [95% CI: 0.076-0.74])接受手术的可能性较小。在接受手术的患者中，只有非英语患者的手术时间明显长于英语患者（风险比[HR] 0.64 [95% CI: 0.43-0.97]）。结论：语言是影响CI手术持续时间和手术时间的潜在持久因素。未来的工作应该考虑目标策略，以考虑这些因素，作为改善CI访问的一种方式。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学

CiteScore

6.70

自引率

2.90%

发文量

250

审稿时长

2-4 weeks

期刊介绍： Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.