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Elderly Health

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Elderly people who are hearing impaired use fewer health services than would be expected

Impaired hearing in elderly people can lessen their psychosocial and physical functioning, as well as diminish their quality of life. It also may interfere with their communication with health care providers, perhaps affecting their understanding of instructions about medication, diet, or other therapeutic recommendations, and hearing problems may lead them to avoid using health care services. Little is known about the degree to which hearing impairment affects use of health care services by the elderly.

A recent study of elderly members of the large Kaiser health maintenance organization found that hearing impairment tripled the likelihood of making at least one visit to a health care provider. Once they made that initial contact, however, these members were no more likely to make subsequent visits than members who were not hearing impaired, despite expectations to the contrary.

These results suggest several possible explanations, according to Carla A. Green, Ph.D., M.P.H., and Clyde R. Pope, Ph.D., of Kaiser Permanente Center for Health Research. One, hearing impairment per se is not a condition that requires much increased use of health services. Two, providers and patients are adequately compensating for the difficulties associated with hearing impairment. Or three, hearing impaired people do not seek or are not receiving a level of care appropriate to the physical and psychosocial dysfunction that is associated with hearing loss. The researchers suggest further studies to explore whether underuse of health care services for elderly people who are hearing impaired indeed exists and, if it does, whether it stems from clinician or patient attitudes about hearing impairment and its consequences, from the lack of available treatments, or from some other factor.

This research was supported in part by the Agency for Healthcare Research and Quality (National Research Service Award training grant T32 HS00069). The researchers examined the association of hearing impairment with the use of any health service among 1,436 randomly selected 65-year-old Kaiser members, after controlling for the effects of depression and other chronic illnesses known to affect health service use. Among these people, 85 percent used outpatient services in their 65th year, and 15 percent had prior diagnoses of hearing impairment or deafness in one or both ears.

See "Effects of hearing impairment on use of health services among the elderly," by Drs. Green and Pope, in the August 2001 Journal of Aging and Health 13(3), pp. 315-328.

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