[Skip to Content]
[Skip to Content Landing]
Review
October 2017

The Economic Impact of Adult Hearing Loss: A Systematic Review

Author Affiliations
  • 1Department of Otolaryngology–Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland
  • 2Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland
  • 3The Boston Consulting Group, New York City, New York
  • 4Department of Gastroenterology, Johns Hopkins School of Medicine, Baltimore, Maryland
  • 5Centers for Medicare & Medicaid Services, Baltimore, Maryland
  • 6Johns Hopkins Welch Medical Library, Baltimore, Maryland
  • 7Johns Hopkins Carey School of Business, Baltimore, Maryland
JAMA Otolaryngol Head Neck Surg. 2017;143(10):1040-1048. doi:10.1001/jamaoto.2017.1243
Key Points

Question  What is the economic impact of hearing impairment?

Findings  In this systematic review, direct medical expenditures and indirect costs associated with hearing impairment were assessed. In the United States, estimates of the economic cost of lost productivity varied from $1.8 to $194 billion, and direct medical costs ranged from $3.3 to $12.8 billion.

Meaning  Hearing loss is associated with billions of dollars of excess costs in the United States, but significant variance is seen between studies. A rigorous, comprehensive estimate of the economic impact of hearing loss is needed to help guide policy decisions around the management of hearing loss in adults.

Abstract

Importance  Hearing impairment (HI) is highly prevalent in older adults and has been associated with adverse health outcomes. However, the overall economic impact of HI is not well described.

Objective  The goal of this review was to summarize available data on all relevant costs associated with HI among adults.

Evidence Review  A literature search of PubMed, Embase, the Cochrane Library, CINAHL, and Scopus was conducted in August 2015. For this systematic review, data extraction and quality assessment were performed by 2 independent reviewers. Eligibility criteria for included studies were presence of quantitative estimation of economic impact or loss of productivity of patients with HI, full-text English-language access, and publication in an academic, peer-reviewed journal or government report prior to August 2015. This review follows the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. A meta-analysis was not performed owing to the studies’ heterogeneity in outcomes measures, methodology, and study country.

Findings  The initial literature search yielded 4595 total references. After 2043 duplicates were removed, 2552 publications underwent title and abstract review, yielding 59 articles for full-text review. After full-text review, 25 articles were included. Of the included articles, 8 incorporated measures of disability; 5 included direct estimates of medical expenditures; 8 included other cost estimates; and 7 were related to noise-induced or work-related HI. Estimates of the economic cost of lost productivity varied widely, from $1.8 to $194 billion in the United States. Excess medical costs resulting from HI ranged from $3.3 to $12.8 billion in the United States.

Conclusions and Relevance  Hearing loss is associated with billions of dollars of excess costs in the United States, but significant variance is seen between studies. A rigorous, comprehensive estimate of the economic impact of hearing loss is needed to help guide policy decisions around the management of hearing loss in adults.

×