Hearing Loss increases cost and creates breakdowns in Medical Care

Hearing loss is associated with adverse mental health conditions, including depression and Alzheimer's.

Depression

Depression is an expensive health problem. Health care costs for older adults with depression are approximately 50 percent higher than for those without depression (Unützer and colleagues, 1997). Older adults with depression are more likely to be admitted to a hospital or a nursing home, visit their physician, and to be prescribed multiple medications.

Depression is associated with:

  • Increased mortality rates
  • Cancer1
  • Myocardial infarction2
  • Long-term care residents3
  • Poorer quality life, worse pain control4

Depression combined with hearing loss and multiple co-existing medical conditions poses a very serious risk. There is ample evidence that the more serious the depression, the greater the risk to declining health.


Alzheimer's Disease

In 2013, the direct costs of caring for those with Alzheimer’s to American society will total an estimated $203 billion, including $142 billion in costs to Medicare and Medicaid. Total payments for health care, long-term care and hospice for people with Alzheimer’s and other dementias are projected to increase from $203 billion in 2013 to $1.2 trillion in 2050 (in current dollars).

The average per-person Medicare costs for those with Alzheimer’s and other kinds of dementia are three times higher than for those without these conditions, and 19 times higher than the average for all other seniors. (Alz.org)

In some cases, people have been misdiagnosed with Alzheimer’s disease because of their inability to follow directions or conversations, when the actual cause was an untreated hearing loss.

1(Mossey 1990, Penninx et al. 2001, Evans 1999)
2(Frasure-Smith 1993, 1995)
3(Katz 1989, Rovner 1991, Parmelee 1992; Ashby 1991;Shah 1993, Samuels 1997)
4(Evans 1999)

Hearing loss is linked to three-fold increase in falling

In 2000, falls among older adults cost the U.S. health care system over $19 billion dollars ($30 billion in 2010 dollars; http://www.cdc.gov/homeandrecreationalsafety/falls/fallcost.html). With an aging population, both the number of falls and the costs to treat fall injuries are likely to increase. One in three adults age 65 years and older experiences a fall each year.

  • Of those who fall, 20% to 30% suffer moderate to severe injuries that make it hard for them to get around or live independently, and increase their risk of early death

  • Older adults are hospitalized for fall-related injuries five times more often than they are for injuries from other causes

  • In 2009, emergency departments treated 2.4 million non-fatal fall injuries among older adults; more than 662,000 of these patients had to be hospitalized

Breakdowns in Medical Care

Hearing loss causes additional medical costs because it contributes to non-compliance or adherence to treatment plans. Brandeis University researchers recently concluded that older adults with mild-to-moderate hearing loss expend so much energy on hearing accurately that their ability to remember spoken language suffers as a result.

"This study is a wake-up call to anyone who works with older people, including health care professionals, to be especially sensitive to how hearing loss can affect cognitive function," said Dr. Arthur Wingfield, Professor of Neuroscience at the Volen National Center for Complex Systems at Brandeis University.

When hearing loss and short-term memory interfere with the doctor-patient communications, serious non-compliance and complications may occur. Patients may not understand their doctor’s instructions or feel too overwhelmed or embarrassed to ask follow up questions.

With little explanation (and lack of hearing and understanding what is said) regimens may not be followed correctly, or a person may take a break from a drug, not understanding the importance of completing the regimen. Many times, patients simply don’t understand the doctor’s orders.

“It’s not uncommon for a patient to be confused or overwhelmed by a diagnosis or treatment plan. Complicated medical procedures or decisions can overwhelm patients to the point that they feel that they cannot, or should not, ask questions of their providers. However, this lack of patient involvement in decision making can lead to decreased patient compliance, higher costs, and less than favorable care outcomes.”1

A review published in the August 2005 issue of the New England Journal of Medicine reported that of all medication-related hospital admissions in the United States, 33 to 69 percent are due to poor medication adherence. These admissions cost about $100 billion a year.

In another report by the New England Healthcare Institute, it was found that not taking medications as prescribed leads to poorer health, more frequent hospitalization, a higher risk of death and as much as $290 billion annually in increased medical costs. A 2006 report from the Institute of Medicine reported medication errors harm 1.5 million people every year and cost at least $3.5 billion dollars in extra medical costs.

1http://www.piperreport.com/blog/2013/03/28/patient-engagement-costs-improve-outcomes/