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Modification of the Association Between Hearing Trouble and Satisfaction With Care by Accompaniment to Health Care
Nicholas S Reed1,2,3, Sarah Y Bessen2,4, Pablo Martinez-Amezcua2,3
1Optimal Aging Institute, NYU Grossman School of Medicine, New York, New York, USA.
Background:
Hearing loss affects nearly two-thirds of adults over the age of 70 years, and is associated with lower satisfaction with health care, which may be mediated by patient-provider communication barriers. Accompaniment, the presence and support of a companion during health care interactions, may modify the association between hearing and satisfaction with care by providing an intermediary to assist with communication.
Methods:
Cross-sectional study of 9698 Medicare beneficiaries from the 2016 Medicare Current Beneficiaries Survey. We used regression models to estimate the association between self-reported trouble hearing and satisfaction with care, which was measured through reported satisfaction with overall quality of care, satisfaction with information provided, and satisfaction with provider's concern. Interaction terms and stratification by being accompanied to healthcare visits were used to assess if accompaniment modified the association between hearing loss and satisfaction with care.
Results:
Nearly 45% of Medicare beneficiaries reported at least a little trouble hearing. Adults with a little trouble hearing (Odds Ratio [OR] = 1.168; 95% Confidence Interval [CI] = 1.047-1.302) and a lot of trouble hearing (OR = 1.293; 95% CI = 1.043-1.603) had higher odds of being dissatisfied with the quality of their health care over the previous year compared to those with no trouble hearing. Among accompanied participants, no association was found between level of hearing trouble and dissatisfaction with care. Among unaccompanied adults, trouble with hearing was associated with higher odds of dissatisfaction. The associations were consistent across the three dissatisfaction outcomes.
Conclusions:
Medicare beneficiaries with hearing loss had higher odds of dissatisfaction with health care over the past year compared to those without functional hearing loss. Stratified models suggest that accompaniment may modify the association between hearing and dissatisfaction with care. Future research should consider interventions to support unaccompanied adults with hearing loss during health care interactions.
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