Hearing aids tied to less hospitalization for older U.S. adults

(Reuters Health) - Older adults with hearing loss are less likely to be hospitalized or to visit the emergency room when they wear hearing aids, compared to those who don’t, a U.S. study suggests.

Researchers examined Medicare payment data collected in 2013 and 2014 for 1,336 adults 65 and older with hearing loss. Overall, 734 people, or 55 percent, didn’t wear hearing aids.

During the study period, 24 percent of people with hearing aids and 26 percent of those without the devices visited an emergency room at least once, the study found. With hearing aids, 20 percent of people were hospitalized, compared to 22 percent without the devices.

With hearing aids, however, healthcare costs were not necessarily lower: more people with the devices had at least one check up at a clinic or doctor’s office, and people with hearing aids also averaged 1.4 more doctor visits than those without the devices.

“We hypothesize that use of hearing aids helps individuals with severe hearing loss to communicate better with their physicians and to have a more active lifestyle compared with those who do not use hearing aids,” said lead study author Elham Mahmoudi of the University of Michigan in Ann Arbor.

Hearing aids were also associated with $1,125 more a year in total healthcare costs, as well as $325 more in annual out-of-pocket spending for patients, the study found.

This was unexpected, Mahmoudi said by email.

“However, the $1,125 estimated increase in healthcare costs associated with hearing aids was below the average $2,000 to $7,000 price of hearing aids,” Mahmoudi added.

Medicare, the U.S. health insurance program for people 65 and older, doesn’t cover hearing aids even though an estimated two-thirds of elderly people have hearing loss by age 70, the researchers note in JAMA Otolaryngology-Head & Neck Surgery.

Hearing loss is a major cause of poor communication for older adults, which can result in lower patient satisfaction, less compliance with prescribed medications and recommended treatments, more utilization of health services and higher medical costs, the study authors write.

While hearing aids were associated with higher total healthcare spending and out-of-pocket costs for patients, the devices were also linked to $71 less in annual Medicare spending, the study found.

“Financial barriers to obtaining and fitting hearing aids are noted as the main reasons people with hearing loss do not use them,” Mahmoudi said. “In deciding on insurance coverage for hearing aids, insurance companies and the Centers for Medicare and Medicaid should consider the long-term efficacy of these devices.”

The study wasn’t a controlled experiment designed to prove whether or how hearing aids might directly impact health use, costs or patient outcomes.

Another drawback is that researchers lacked objective data on the severity of hearing loss, relying instead on information reported by patients in a survey.

Even when people do get hearing aids, they may wear the devices for varying amounts of time during a typical day or choose to use them in different settings and circumstances, noted Margaret Wallhagen of the University of California, San Francisco. These things may all impact how much hearing aids contribute to patient health or utilization of healthcare services, Wallhagen, author of an accompanying editorial, said by email.

“Trying to determine the reason for lower ER visits and hospitalizations is, unfortunately, rather speculative,” Wallhagen said. “In this sample, those without hearing aids had somewhat higher rates of chronic conditions and fewer economic resources and may be more likely to use ERs as a source of health care but we definitely need additional data to elucidate the effects of hearing aids on healthcare use.”

SOURCE: and JAMA Otolaryngology- Head & Neck Surgery, online April 26, 2018.