Patients with age-related hearing loss (HL) may be at higher risk for undesirable health outcomes because HL may tend to isolate individuals and reduce necessary communications about health problems to health care providers and family members, or lead to low understanding of the proper use of medications. The extent to which HL affects the process of care for other chronic conditions and/or is associated with poor health outcomes is not well understood. This project will use medical care administrative insurance billing data from older adults to compare accepted medical care quality measures between propensity-score matched patients with and without HL. The measures to be examined will include 1) difference in medication non-adherence, 2) hospital and emergency room use for ambulatory-care sensitive conditions (ACSCs), 3) cost of care and 4) death rates. These outcome and quality measure are commonly used in the analysis of medical care billing data to assess the process of care, health outcomes, and cost of care, but have not been applied to the study of hearing-related outcomes. Thus, this project will be the first to examine utilization patterns for patients with HL using large archival data bases and to apply the latest quasi-experimental methods to HL research. The results from this project will clarify the financial ramifications of HL and document the magnitude of differences in medical care use and health outcomes in older adults with HL compared to matched controls. Findings will help inform future studies to examine how HL may affect medication non-adherence, patient satisfaction and access to care.

Public Health Relevance

Hearing loss is among the most common chronic conditions of aging, but only a small percentage of older adults access the hearing health care system for diagnosis and treatment. These findings, and the growing population of older adults, call attention to hearing loss as a public health problem and emphasize the critical need for evidence of the impact of hearing loss on utilization of the healthcare system and health outcomes. Direct and indirect effects of age-related hearing loss, such as breakdowns in communication between older patients and their providers, may lead to exacerbation of other chronic health conditions, adversely affecting access to care, which may increase medication non-adherence, hospitalizations, emergency room visits, healthcare costs, and mortality.

National Institute of Health (NIH)
National Institute on Deafness and Other Communication Disorders (NIDCD)
Exploratory/Developmental Grants (R21)
Project #
Application #
Study Section
Health Services Organization and Delivery Study Section (HSOD)
Program Officer
Donahue, Amy
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Medical University of South Carolina
Other Health Professions
Schools of Allied Health Profes
United States
Zip Code
Simpson, Annie N; Simpson, Kit N; Dubno, Judy R (2018) Healthcare Costs for Insured Older U.S. Adults with Hearing Loss. J Am Geriatr Soc 66:1546-1552
Simpson, Annie N; Simpson, Kit N; Dubno, Judy R (2016) Higher Health Care Costs in Middle-aged US Adults With Hearing Loss. JAMA Otolaryngol Head Neck Surg 142:607-9