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Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
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Health Service Utilization in Children With Permanent Hearing Loss: A Nested Case Control Study.

Janet Olds1,2,3, Elizabeth M Fitzpatrick2,4, Stuart G Nicholls5

  • 1Children's Hospital of Eastern Ottawa, Ontario, Canada (CHEO).

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|November 25, 2025
PubMed
Summary
This summary is machine-generated.

Children with permanent hearing loss (PHL) experience more chronic complex conditions (CCCs) and utilize health services more frequently in their first two years. Early identification of PHL is crucial for optimizing care and health system planning.

Keywords:
Childhood hearing lossHealth services utilizationPediatric chronic complex conditionsPediatric permanent hearing loss

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Area of Science:

  • Pediatric Health Services Research
  • Audiology and Speech Pathology
  • Public Health Policy

Background:

  • Permanent hearing loss (PHL) affects approximately 40% of children with associated disabilities.
  • Limited understanding exists regarding health service utilization patterns in children with PHL.
  • Chronic complex conditions (CCCs) are common comorbidities in children with PHL.

Purpose of the Study:

  • To compare health service utilization between children with PHL and matched controls.
  • To investigate the prevalence of CCCs in children with PHL compared to controls.
  • To analyze health service use in relation to PHL diagnosis era and CCCs.

Main Methods:

  • A nested case-control study utilizing population-based health administrative data.
  • Inclusion of 591 children with PHL and 2951 matched controls from a clinical database.
  • Analysis of health services encounters and CCCs within two years postbirth, considering data from 1991-2013.

Main Results:

  • Children with PHL had significantly higher rates of CCCs (39.9%) compared to controls (8.1%).
  • PHL cases demonstrated increased health service utilization, including emergency visits (IRR 1.25), outpatient visits (IRR 1.44), and inpatient hospitalizations (IRR 1.62).
  • The association between PHL and increased health service use remained significant after adjusting for CCCs and diagnosis era.

Conclusions:

  • Children with PHL exhibit greater health service use and a higher burden of CCCs in early life.
  • Early identification of permanent hearing loss is essential for improving child outcomes.
  • Findings support the need for proactive health system planning to accommodate the needs of children with PHL.