Hearing loss and high healthcare costs: What’s the link?

People who wear hearing aids might be improving more than their hearing. They might also be in better health overall, according to a recent study.

The study, published in April, used 2013-2014 data from a national survey to evaluate the use of hearing aids among 1,336 adults age 65 or older with self-reported hearing loss. Of those, 602 used hearing aids and 734 didn’t. The goal was to measure overall health care spending as well as the number of emergency department or office visits.

Hearing loss and hospitalization

According to the study, the use of hearing aids was associated with a 2 percent drop in visits to the emergency room and in hospitalizations. There was a 1.40-day increase in office visits, and nights in the hospital were reduced by 0.46 nights. Hearing aids increased total health care spending by $1,125 and out-of-pocket costs by $325, but decreased Medicare spending by $71.

The total annual out-of-pocket spending among older adults who used hearing aids was $534 higher than that of adults who didn’t use them. Of those with hearing aids, 98 percent had at least one office visit over a year, compared with 93 percent of those without hearing aids, and those adults with hearing aids had two additional office visits.

Elham Mahmoudi, Ph.D., of the University of Michigan, the corresponding author on the study, said their main finding was that while using hearing aids reduces the likelihood of emergency room visits and hospitalization, it also increases overall health care costs for users.

Because they relied on survey data, they didn’t have details on the types of emergency room visits or hospitalizations reported, Mahmoudi said, calling the study “a snapshot” of the use of health care services.

Unexpected findings

She said part of the results were unexpected. “I was actually hypothesizing lower health care costs, so that was surprising to see that their health care cost was higher.”

Using just one year’s worth of data is limiting, she said. “Hearing aids in general are expensive. The average cost of hearing aids is between $2,000 to $7,000. And using that data, we couldn’t identify the type of hearing aids that these people used. So it is possible that … the higher total health care costs were due to the higher costs of hearing aids.”

She suggested that if they followed the hearing aid wearers in the survey for a longer time, their health care costs would drop, since they’d be less likely to go to the emergency room or hospital.

Medicare and many private insurers don’t cover hearing aids, hearing exams or fittings. In the U.S., only 14 percent of adults age 50 or older with hearing issues use hearing aids, according to the study.

Hearing loss is the third most common chronic condition among older adults and is linked to a number of other medical and social problems, including hypertension and diabetes. The study found lower numbers of both conditions among those wearing hearing aids, suggesting hearing aid wearers might be in better health overall. Mahmoudi noted that other studies have shown hearing loss is associated with dementia and Alzheimer’s, and she said using hearing aids might help prevent those as well.

Advocacy for greater hearing aid accessibility

Mahmoudi said the authors are advocating for Medicare and insurers to cover hearing aids, believing it will reduce hospitalizations or emergency room visits.

But there are multiple factors in why people don’t use hearing aids, and the reasons why aren’t always clear. In the study, a higher percentage of hearing aid users were white, as opposed to Hispanic or African-American. Those using hearing aids were more likely to be fluent in English, have a college degree, and have a high income level; those who didn’t use hearing aids were less likely to be fluent in English or to have a high school diploma, and generally had lower income levels.

A higher percentage of people who lived in the South didn’t use hearing aids, compared to other regions. Mahmoudi suggested this could have to do with the lower rate of social services in certain states, or cultural issues. This study is the first step toward more detailed studies, she said.

One of their other studies, underway now, is to see why people don’t use hearing aids. “Financial barriers are a huge issue,” she said, adding that many people decide they don’t need hearing aids because of the price. Another of their studies is using insurer claims data over a longer period of time to track people with hearing loss and their health care use and costs.

There are only a handful of companies that supply hearing aids, she said. “The hope is if they’re pressured to bring their costs down to large insurance companies, like Medicare and other private insurance companies, the price should drop.”

Despite the cost, she encourages people to get their hearing checked regularly. “If people cannot hear, they cannot communicate well with their physicians, with their family members, with society as a whole.”

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