Clinical Characteristics and Hearing Aid Uptake Rate of Patients Seen at the Community Hearing Clinic: A Model of Upstream Preventive Care and Earlier Intervention

Abstract

Background and Aim: Presbyacusis is one of the most common causes of hearing loss for seniors age above 60 years. Yet diagnostic hearing tests are not readily accessible to seniors in the community. Since 2018, the Ministry of Health in Singapore started a pilot program to screen them for their visual, oral, and hearing health in the community and improve accessibility to hearing healthcare. We describe the clinical characteristics of seniors presenting to Community Hearing Clinic (CHC) and compared hearing aid uptake rates with patients seen at a tertiary hospital. Methods: Retrospective cross-sectional descriptive study on Singaporeans with hearing difficulties presenting to the community clinics. Results: Attendance rates were generally positive at more than 80% and is comparable to the specialist outpatient clinic at the tertiary hospital. Hearing aid uptake rates were comparable between CHC and tertiary hospital at 61.9% and 66.9% respectively. Despite having better accessibility with direct access to the audiologists, and more financial subsidies, the eventual uptake rates of hearing aids are not clinically different at the CHC. Conclusion: CHC may be a viable model of improving accessibility to hearing healthcare with audiologists providing the 1st level of triaging safely. However, the cost-effectiveness of this model remains to be seen. Further health service research studies are warranted to determine the cost-effectiveness of sandbox CHC. Right-siting and expanding the sandbox to include access to hearing aid subsidies in private clinics may further help with this move beyond hospital to the community in line with our public health vision.   Keywords: Community health services; audiology; hearing aids; financing; governmental