Racial and Ethnic Disparities Among Hearing Aid and Cochlear Implant Patients at a Tertiary-Level Academic Otology Practice

Abstract

Utilization of hearing aids (HAs) and cochlear implants (CIs) is limited, with our group previously demonstrating that non-White patients pursue CI less than White patients. The aim of this study was to compare the demographic makeup of patients more recently evaluated for both interventions in our clinic, exploring the influence of insurance on pursuit of HA, and whether changes have occurred in CI uptake. Retrospective chart review. Tertiary-level academic otology clinic. All patients (18 yr or older) evaluated for an HA or CI in 2019 were included. Demographic variables (including race, insurance, and socioeconomic status) were compared between patients who did and did not obtain an HA or CI. In 2019, 390 patients underwent an HA evaluation, and 195 patients received a CI evaluation. Relative to patients evaluated for CI, patients evaluated for HA were more likely to be White (71.3% versus 79.4%, p = 0.027). Examining factors that affected HA purchase, Black race (odds ratio, 0.32; 95% confidence interval, 0.12-0.85; p = 0.022), and lower socioeconomic status (odds ratio, 0.99; 95% confidence interval, 0.98-1.00; p = 0.039) were associated with decreased odds. Demographic variables and AzBio quiet scores were not associated with decision to pursue CI surgery. White patients comprised a larger proportion of HA evaluations than CI evaluations. Furthermore, White patients and those of higher socioeconomic status were more likely to purchase HA. Improved outreach and expanded insurance benefits for HA are needed to ensure equal access to aural rehabilitation.