Hearing aid fitting in adults: results of a cost-effectiveness study

Abstract

Objective. Despite its high prevalence (≤ 20% in adults) and the adverse impact on daily life, hearing impairment is a neglected problem. Despite the fact that < 25% of the hearing-impaired seek help and acquire hearing aids in the Netherlands, hearing aid provision and rules for reimbursment are questioned. This is the reason for a cost-effectiveness study. Materials and methods. Self-reported hearing disability and its impact on quality of life was studied in 60 first-time-users, followed prospectively for 16 weeks after hearing aid fitting. They reported significant benefits in hearing ability, experienced an increased number and quality of social contacts and improved self-assessed personal health. Integrating the positive and negative effects of the intervention in a gain in quality of life, a utility value was obtained. Multiplying this utility value by the number of years the effect is expected to last, yielded Quality Adjusted Life Years. Results. In an economic evaluation, based on a model of tracing and referral and costs per QALY, hearing aid fitting in hearing-impaired adults was compared to the effectiveness of other health care interventions and, as a result, placed near the top of a QALY league table. Conclusions. Hearing aid fitting is a very cost-effective intervention.