Health Service Utilization in Children With Permanent Hearing Loss: A Nested Case Control Study

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.