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在单侧聋和非对称性听力损失中使用耳植入器的医疗保险覆盖

Donna L Sorkin¹, Oliver F Adunka², Nichole Westin¹

¹American Cochlear Implant Alliance, Salary from American Cochlear Implant Alliance, McLean, Virginia.

Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology

|July 28, 2023

概括

确保对耳植入物 (CI) 进行单侧耳聋 (SSD) 和非对称听力损失 (AHL) 的保险覆盖仍然具有挑战性. 对等评价对于上诉最有效,但SSD/AHL的CI访问需要更多的研究和宣传.

科学领域:

听力学听力学是指听力学.
耳鼻喉科耳鼻喉科耳鼻喉科
医疗保健服务研究医疗服务研究

背景情况:

对耳植入物 (CI) 对单侧聋 (SSD) 和非对称听力损失 (AHL) 的兴趣日益增加.
CI诊所报告这些患者获得保险的成功程度各不相同.
了解保险覆盖的趋势和挑战对于患者获得医疗服务至关重要.

研究的目的:

评估SSD或AHL患者的CI的保险覆盖范围.
为了确定成功获得保险覆盖的差异.
探索诊所用来克服拒绝覆盖的策略.

主要方法:

一个SurveyMonkey调查问卷从2021年8月至10月分发给105名美国CI临床医生.
收集关于儿科和成人SSD/AHL患者保险覆盖体验的数据.
进行后续访谈以收集额外的定性见解.

主要成果:

在2019年FDA指导方针扩展后,SSD CI手术的显著增加,除了低体积诊所.
少数诊所很少或不经常获得SSD CI初始覆盖率 (5%和8%).
同行评审被证明是最成功的上诉策略,虽然耗时.

结论:

对于SSD/AHL中CI的保险覆盖是不一致的,在幼儿中发现了挑战.
克服最初的拒绝往往需要上诉,主要是通过对等审查.
扩大SSD/AHL的CI访问需要临床研究,FDA指南更新,公众意识和宣传.

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相关概念视频

The Cochlea

The Cochlea

The cochlea is a coiled structure in the inner ear that contains hair cells—the sensory receptors of the auditory system. Sound waves are transmitted to the cochlea by small bones attached to the eardrum called the ossicles, which vibrate the oval window that leads to the inner ear. This causes fluid in the chambers of the cochlea to move, vibrating the basilar membrane.