Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel
Journal cover image

A pragmatic clinical trial of hearing screening in primary care clinics: cost-effectiveness of hearing screening.

Publication ,  Journal Article
Dubno, JR; Majumder, P; Bettger, JP; Dolor, RJ; Eifert, V; Francis, HW; Pieper, CF; Schulz, KA; Silberberg, M; Smith, SL; Walker, AR ...
Published in: Cost Eff Resour Alloc
June 25, 2022

BACKGROUND: Hearing loss is a high prevalence condition among older adults, is associated with higher-than-average risk for poor health outcomes and quality of life, and is a public health concern to individuals, families, communities, professionals, governments, and policy makers. Although low-cost hearing screening (HS) is widely available, most older adults are not asked about hearing during health care visits. A promising approach to addressing unmet needs in hearing health care is HS in primary care (PC) clinics; most PC providers (PCPs) do not inquire about hearing loss. However, no cost assessment of HS in community PC settings has been conducted in the United States. Thus, this study conducted a cost-effectiveness analysis of HS using results from a pragmatic clinic trial that compared three HS protocols that differed in the level of support and encouragement provided by the PC office and the PCPs to older adults during their routine visits. Two protocols included HS at home (one with PCP encouragement and one without) and one protocol included HS in the PC office. METHODS: Direct costs of the HS included costs of: (1) educational materials about hearing loss, (2) PCP educational and encouragement time, and (3) access to the HS system. Indirect costs for in-office HS included cost of space and minimal staff time. Costs were tracked and modeled for each phase of care during and following the HS, including completion of a diagnostic assessment and follow-up with the recommended treatment plan. RESULTS: The cost-effectiveness analysis showed that the average cost per patient is highest in the patient group who completed the HS during their clinic visit, but the average cost per patient who failed the HS is by far the lowest in that group, due to the higher failure rate, that is, rate of identification of patients with suspected hearing loss. Estimated benefits of HS in terms of improvements in quality of life were also far greater when patients completed the HS during their clinic visit. CONCLUSIONS: Providing HS to older adults during their PC visit is cost-effective and accrues greater estimated benefits in terms of improved quality of life. TRIAL REGISTRATION: clinicaltrials.gov (Registration Identification Number: NCT02928107).

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Cost Eff Resour Alloc

DOI

ISSN

1478-7547

Publication Date

June 25, 2022

Volume

20

Issue

1

Start / End Page

26

Location

England

Related Subject Headings

  • Health Policy & Services
  • 3801 Applied economics
  • 1402 Applied Economics
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Dubno, J. R., Majumder, P., Bettger, J. P., Dolor, R. J., Eifert, V., Francis, H. W., … Tucci, D. L. (2022). A pragmatic clinical trial of hearing screening in primary care clinics: cost-effectiveness of hearing screening. Cost Eff Resour Alloc, 20(1), 26. https://doi.org/10.1186/s12962-022-00360-5
Dubno, Judy R., Pranab Majumder, Janet Prvu Bettger, Rowena J. Dolor, Victoria Eifert, Howard W. Francis, Carl F. Pieper, et al. “A pragmatic clinical trial of hearing screening in primary care clinics: cost-effectiveness of hearing screening.Cost Eff Resour Alloc 20, no. 1 (June 25, 2022): 26. https://doi.org/10.1186/s12962-022-00360-5.
Dubno JR, Majumder P, Bettger JP, Dolor RJ, Eifert V, Francis HW, et al. A pragmatic clinical trial of hearing screening in primary care clinics: cost-effectiveness of hearing screening. Cost Eff Resour Alloc. 2022 Jun 25;20(1):26.
Dubno, Judy R., et al. “A pragmatic clinical trial of hearing screening in primary care clinics: cost-effectiveness of hearing screening.Cost Eff Resour Alloc, vol. 20, no. 1, June 2022, p. 26. Pubmed, doi:10.1186/s12962-022-00360-5.
Dubno JR, Majumder P, Bettger JP, Dolor RJ, Eifert V, Francis HW, Pieper CF, Schulz KA, Silberberg M, Smith SL, Walker AR, Witsell DL, Tucci DL. A pragmatic clinical trial of hearing screening in primary care clinics: cost-effectiveness of hearing screening. Cost Eff Resour Alloc. 2022 Jun 25;20(1):26.
Journal cover image

Published In

Cost Eff Resour Alloc

DOI

ISSN

1478-7547

Publication Date

June 25, 2022

Volume

20

Issue

1

Start / End Page

26

Location

England

Related Subject Headings

  • Health Policy & Services
  • 3801 Applied economics
  • 1402 Applied Economics