As many hospitals work to find ways to reduce costs and improve care, a study finds that patients' hearing loss significantly increases their risk for hospital re-admission.
Every year there are more than 35 million hospitalizations in the US, accounting for a third of all health care expenditures. Unfortunately, In many cases, patients return to the hospital quickly: for example, 22% of people who are hospitalized for heart failure return and are readmitted within a month of discharge.
To reduce hospital readmissions, the Medicare program withholds payment to hospitals when patients are readmitted within 30 days of discharge for key conditions. Many hospitals are working hard to find ways to reduce readmissions.
One potentially fruitful approach is suggested by a study by researchers at New York University for the Journal of the American Geriatrics Society. They studied the extent to which hearing loss might affect hospital readmission risk. Using the Medicare Current Beneficiary Survey (MCBS), they identified patients aged 65 and over who said that they had difficulty communicating with health care personnel due to their hearing loss. The researchers compared the hospitalization experiences of those reporting difficulty communicating with those who did not. Among those who were hospitalized, subjects with difficulty communicating with medical personnel had a 32-percent increase in the likelihood of being readmitted within 30 days, compared to those who did not report difficulty. This increased risk took into account differences between the two groups, including age, number of medical problems, and a host of sociodemographic factors.
“People with hearing loss often have difficulty understanding speech in noisy and stressful situations,” said Jan Blustein, MD, PhD, professor of health policy and medicine at New York University’s Robert F. Wagner Graduate School of Public Service, and senior author of the study. “Hospitals are noisy chaotic places, and people with hearing loss may have trouble understanding key information, such as what medicines they should take after discharge, or how they should watch for or manage exacerbation of their symptoms. This puts them at risk for difficulties after they are discharged from hospital.”
Co-author Ji Eun Chang, PhD, assistant professor of public health policy and management at NYU’s College of Global Public Health, notes that “Our study finds that hearing loss is an important risk for hospital readmission.
This hasn’t been shown in previous studies, and it suggests that hospitals can do better by providing hearing assistance to older people who are struggling to hear.”
Dr. Blustein noted that there are several low-cost, low technology approaches to helping older people with hearing loss to hear better. “There are simple devices that cost under $100 that have been successfully used by hospitals to assist hard-of-hearing patients. But few hospitals use them. We hope that our research will help raise awareness of the potential to improve patient care by attending to hearing loss.”