Is it possible to provide free, comprehensive audiologic services to indigent patients?
In this observational cohort study at a preexisting free clinic, 34 patients were identified as eligible for a free hearing aid and 20 of these patients (59%) received hearing aids. The value of services provided was estimated to be $2260 per patient.
It is feasible to provide free, comprehensive audiologic care, including hearing aids and fitting, in a well-established, free clinic model.
Providing a model of a comprehensive free audiologic program may assist other health care professionals in developing their own similar program.
To describe the structure, feasibility, and outcomes of a free subspecialty clinic providing hearing aids to develop a paradigm for other programs interested in implementing similar projects.
Design, Setting, and Participants
A retrospective case series was conducted from September 1, 2013, through March 31, 2016. In a partnership between a free independent clinic for indigent patients and an academic medical center, 54 indigent patients were referred to the clinic for audiograms. A total of 50 of these patients had results of audiograms available for review and were therefore included in the study; 34 of these 50 patients were determined to be eligible for hearing aid fitting based on audiometric results.
Free audiometric testing, hearing aid fitting, and hearing aid donation.
Main Outcomes and Measures
The number of hearing aids donated, number of eligible patients identified, number of patients fitted with hearing aids, and work effort (hours) and start-up costs associated with implementation of this program were quantified.
A total of 54 patients (31 women [57.4%] and 23 men [42.6%]; median age, 61 years; range, 33-85 years) had audiograms performed, and 84 hearing aids were donated to the program. The patients were provided with free audiograms, hearing aid molds, and hearing aid programming, as well as follow-up appointments to ensure continued proper functioning of their hearing aids. Since 2013, a total of 34 patients have been determined to be eligible for the free program and were offered hearing aid services. Of these, 20 patients (59%) have been fitted or are being fitted with free hearing aids. The value of services provided is estimated to be $2260 per patient.
Conclusions and Relevance
It is feasible to provide free, comprehensive audiologic care, including hearing aids and fitting, in a well-established, free clinic model. The opportunity for indigent patients to use hearing aids at minimal personal cost is a major step forward in improving access to high-quality care.
Wertz AP, Mannarelli G, Shuman AG, McKean EL. Comprehensive Hearing Aid Intervention at a Free Subspecialty Clinic. JAMA Otolaryngol Head Neck Surg. Published online June 15, 2017. doi:10.1001/jamaoto.2017.0680