使用VA医疗保健的美国退伍军人的助听器获取模式

IF 2.7 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Laura Coco PhD, AuD, Loretta Shields PhD, Rachel Phillips MS, Stephanie Pesa AuD, Matthew Hamilton-Sutherland AuD, Kathleen F. Carlson PhD, MS, Dawn L. Konrad-Martin PhD, Kelly M. Reavis PhD, MS, MPH
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引用次数: 0

摘要

本观察性研究的主要目的是描述在12年的研究期间,在意外听力损失诊断后接受和未接受助听器的退伍军人人群。我们还试图衡量听力损失严重程度与助听器购置之间的关系,并探讨这种关系如何根据退伍军人的城市/农村居住状况而有所不同。了解临床或人口统计学特征与美国退伍军人医疗保健用户获得助听器的关联可能有助于更有效地治疗听力损失。方法:我们检查了所有退伍军人的电子健康记录,以确定2011年1月至2023年6月期间诊断为偶发性(新)听力损失的参与者。使用国际疾病分类诊断代码和听力图结果确定听力损失。助听器配件使用现行程序术语代码进行识别。使用泊松回归模型计算获得助听器的比率和95%置信区间。结果在256409名诊断为偶发性听力损失的退伍军人中,研究期间佩戴助听器的比例为81% (n = 206438)。在接受助听器的退伍军人中,较大比例的人是老年人、男性、白人、非西班牙裔、已婚和高收入群体。从听力损失诊断到助听器配戴的平均时间小于1年(M = 200天;SD = 502天)。与农村退伍军人相比,城市退伍军人的听力损失严重程度与助听器获得之间的相关性更强,并且听力损失严重程度与城乡状况之间存在显著的相互作用(p <;。)。这项大型的全国性队列研究首次描述了使用VA医疗保健的退伍军人获得助听器的模式。助听器使用率总体较高,但因人口和地理因素而异。观察到的差异可能反映了结构性挑战或感知需求的变化。这些发现可以帮助有针对性的VA项目,旨在提高听力保健的及时吸收,特别是在农村退伍军人群体中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hearing aid acquisition patterns among US Veterans who use VA health care

Purpose

The primary objective of this observational study was to describe the population of Veterans who did and did not receive a hearing aid following an incident hearing loss diagnosis during the 12-year study period. We also sought to measure the relationship between hearing loss severity and hearing aid acquisition and explore how this association differs according to Veterans’ urban/rural residential status. Understanding associations of clinical or demographic characteristics with hearing aid acquisition by US Veteran health care users may contribute to more effective treatment of hearing loss.

Method

We examined all Veteran electronic health records to identify participants with an incident (new) hearing loss diagnosis between January 2011 and June 2023. Hearing loss was identified using International Classification of Diseases diagnosis codes and audiogram results. Hearing aid fittings were identified using Current Procedural Terminology codes. Poisson regression models were used to compute rate ratios and 95% confidence intervals of hearing aid acquisition.

Results

Among 256,409 Veterans with an incident hearing loss diagnosis, the prevalence of hearing aid acquisition was 81% (n = 206,438) during the study period. Among Veterans who received hearing aids, a greater proportion were older, male, White, non-Hispanic, married, and from higher income groups. The average number of days between hearing loss diagnosis and hearing aid fitting was less than 1 year (M = 200 days; SD = 502 days). The association between hearing loss severity and hearing aid acquisition was stronger among urban Veterans compared to rural Veterans, and there was a significant interaction between hearing loss severity and urban/rural status (p < .0001).

Conclusions

This large, national cohort study provides the first description of hearing aid acquisition patterns among Veterans using VA health care. Hearing aid uptake was high overall but varied by demographic and geographic factors. The observed differences may reflect structural challenges or variations in perceived need. These findings can help inform targeted VA programs aimed at improving timely uptake of hearing care, particularly among rural Veteran populations.

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来源期刊
Journal of Rural Health
Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
7.60
自引率
6.10%
发文量
86
审稿时长
>12 weeks
期刊介绍: The Journal of Rural Health, a quarterly journal published by the NRHA, offers a variety of original research relevant and important to rural health. Some examples include evaluations, case studies, and analyses related to health status and behavior, as well as to health work force, policy and access issues. Quantitative, qualitative and mixed methods studies are welcome. Highest priority is given to manuscripts that reflect scholarly quality, demonstrate methodological rigor, and emphasize practical implications. The journal also publishes articles with an international rural health perspective, commentaries, book reviews and letters.
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