Access to the provision of hearing health in patients with presbycusis: A new model of care for public hospitals in Chile

Abstract

Introduction: Presbycusis affects a significant proportion of elderly subjects with negative impact in the quality of life and economic costs for society. In Chile, GES guarantees the provision of hearing aids, but the access to medical specialists is scarce. Objective: Explore a model of care for patients with Presbycusis in the public sector of health that provides a se­cure protocol of care and reduces the barriers to access. Material and Method: Patients that attended the outpatient clinic of Otorhinolaryngology from Hospital Padre Hurtado be­cause of hearing loss, between the months of June and November of 2022. All patients were subject to anamnesis, otomicroscopy, and tonal audiometry. Red flags in the audiometry: asymmetric hearing loss or the presence of an air-bone gap. Descriptive statistical analysis with SSPS. The protocol was approved by the local ethics committee. Results: We included 267 patients, 57, 7% female, median age 77 years (range 65 to 100). Earwax prevalen­ce 15.7% (IC 95% 11.6%, 20.6%), chronic otitis media prevalence 7.5% (IC 95% 4.5%, 10.9%). Audiometric red flags: asymmetric hearing loss in 21.7% (IC 95% 17.2%-26.6%), air-bone gap in 12.4% (IC 95% 8.6%-16.5%). In 62, 2% (IC 95% 56, 2%-68, 2%) of the subjects there were no red flags or earwax. Conclusion: A model of care for patients with Presbycusis that includes direct assessment with audiometry in the public health system is safe in at least 62, 2% of the cases. This observation can lead to an important reduction in the waiting time to access a hearing aid.