Evolving Trends in Cochlear Implantation: A Critical Look at the Older Population

Agabigum, Bora; Mir, Ahsan; Arianpour, Khashayar; Svider, Peter F.; Walsh, Erika M.; Hong, Robert S.

doi:10.1097/mao.0000000000001909

Cited by 17 publications

(12 citation statements)

References 15 publications

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“…This finding is certainly aligned with previous data showing increasing usage of CI in the elderly population. For example, Agabigum et al (10) documented a 124.6% increase in CIs in the Medicare population from 2007 to 2016; given differences in our exact numbers, their analysis likely also included performing entities listed as organizations in the data set (10). Regardless of the exact numbers, there appears to be a notable trend in increased usage of CIs across the United States, which is also apparent after stratifying each geographic region.…”

Section: Discussionmentioning

confidence: 99%

“…To date, few studies have characterized nationwide practice patterns and utilization of CI in older populations. In 2018, Agabigum et al (10) used Medicare national summary data to characterize temporal and geographic patterns in CI from 2007 to 2016; they demonstrated a 124.6% increase in utilization and found macroscale geographic variations in CI usage.…”

Section: Introductionmentioning

confidence: 99%

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Geographic Variations in Medicare Cochlear Implantations in the United States

Fujiwara

Wong²,

Ishiyama³

2022

Otol Neurotol

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Objective: To describe national practice patterns and detail geographic and temporal changes in cochlear implantations (CIs) in the Medicare population. Study Design: Cross-sectional analysis. Setting: Medicare B Public Use Files. Patients: Medicare B fee-for-service patients who underwent CI from 2012 to 2019. Intervention(s): Cochlear implantations (Current Procedural Terminology code 69930). Main Outcome Measures: Medicare Part B Public Use Files were used to identify all individual providers who performed CIs from 2012 to 2019. The total number of CIs performed annually was calculated for hospital referral regions (HRRs) as well as U.S. census regions to describe geographic variations and changes over the study period. Average Medicare reimbursement rates were tabulated. Results: From 2012 of 2019, the number of CIs performed in the Medicare population increased from 1,239 to 2,429, representing a 96.0% increase. In each of the four U.S. census regions, there was a statistically significant increase in the number of CIs performed over the study period. However, of 306 HRR in the United States, cochlear implants were performed in only 117 (38.2%), with the median number of CIs in each HRRs 16.7 (interquartile range, 13-24.2) per year. The median weighted average Medicare reimbursement was $1205.49 (interquartile range, 1161.65-1253.46). Conclusions: The number of CIs in the Medicare population has increased from 2012 to 2019. However, widespread geographic variations continue to persist in the United States and represent opportunities toward identifying and acting on the etiologies of persistent disparities in CI.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Geographic Variations in Medicare Cochlear Implantations in the United States

Fujiwara

Wong²,

Ishiyama³

2022

Otol Neurotol

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“…1 Though the number of patients with a CI are increasing over time, the increase is not equitably distributed. 2 In reviewing Medicare Part B national summary procedural datasets between 2007 and 2016, Agabigum et al 2 observed that the West North Central region experienced the greatest increase in CI per capita. In addition, Fakurnejad et al 3 reviewed a commercial insurance database and noted the overall increase in CI was predominantly the result of an increase in CI patients older than 60 years of age.…”

Section: Introductionmentioning

confidence: 99%

Trends in Cochlear Implantation in Texas: An Exploration of Outpatient Discharge Data, 2010 to 2017

Balachandra

Xierali

Nivet

et al. 2021

Ann Otol Rhinol Laryngol

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Objectives: To describe trends in cochlear implantation (CI) disparities in Texas using an all-payer database from 2010 to 2017. Methods: Texas Outpatient Surgical and Radiological Procedure Data, a public use data file, was accessed to analyze outpatient CI cases for Texas. Variables analyzed include patient age, sex, race/ethnicity, and insurance status. Population data from the American Community Survey generated CI utilization rates by patient demographic characteristics. Results: There were 6158 CI cases identified during the study period. The number of CI per year nearly doubled from 497 in 2010 to 961 in 2017. The majority of CI recipients were white (59.5%), male (51.9%), and privately insured (47.9%). All sub-populations statewide had more CI in 2017 compared to 2010, with the overall CI per 100 000 population increasing from 1.98 to 3.50 per 100 000 population. Patients over 75 demonstrated the greatest increase in the CI rate per 100 000 population, increasing from 4.60 in 2010 to 14.30 in 2017. Regarding race/ethnicity, all sub-populations noted an increase in the CI per 100 000 population, with white patients demonstrating the highest rate in 2017, at 4.36 CI per 100 000 population. Asian patients had a 502% increase in the CI rate (from 0.42 to 2.53), compared with 87.9%, 84.4%, and 69.2% increases for white, Black, and Hispanic populations, respectively. Conclusions: CI became more widespread between 2010 and 2017, benefiting certain populations more than others. Black and Hispanic populations had lower CI per 100 000 population than their white peers, while patients >65 years of age accounted for the greatest increase in CI.

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“…However, no data are available regarding ethnic and racial demographics of the US adult CI population. Even large studies of CI utilization (Agabigum et al, 2018;Sorkin, 2013) and CI outcomes (Angelo et al, 2016;Chung et al, 2012;Gifford et al, 2008;Holden et al, 2013;Reeder et al, 2014;Wanna et al, 2014) routinely fail to report race and ethnicity data. The lack of racial/ethnic data for the adult CI population makes it difficult to determine the effects of this study's demographics on our results.…”

Section: Future Directionsmentioning

confidence: 99%

Development of the Cochlear Implant Quality of Life Item Bank

McRackan¹,

Hand²,

Velozo³

et al. 2018

Ear &Amp; Hearing

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Objective: Functional outcomes following cochlear implantation have traditionally been focused on word and sentence recognition, which, although important, do not capture the varied communication and other experiences of adult cochlear implant (CI) users. Although the inadequacies of speech recognition to quantify CI user benefits are widely acknowledged, rarely have adult CI user outcomes been comprehensively assessed beyond these conventional measures. An important limitation in addressing this knowledge gap is that patient reported outcome measures (PROMs) have not been developed and validated in adult CI patients using rigorous scientific methods. The purpose of the present study is to build on our previous work and create an item bank that can be used to develop new PROMs that assess CIQOL in the adult CI population.Design: An online questionnaire was made available to 500 adult CI users who represented the adult CI population and were recruited through a consortium of 20 CI centers in the United States. The questionnaire included the 101 question CIQOL item pool and additional questions related to demographics, hearing and CI history, and speech recognition scores. In accordance with the Patient-Reported Outcomes Measurement Information System (PROMIS), responses were psychometrically analyzed using confirmatory factor analysis (CFA) and item response theory (IRT).Results: Of the 500 questionnaires sent, 371 (74.2%) subjects completed the questionnaire. Subjects represented the full range of age, durations of CI use, speech recognition abilities, and listening modalities of the adult CI population; subjects were implanted with each of the three CI manufacturers' devices. The initial item pool consisted of the following domain constructs: communication, emotional, entertainment, environment, independence, listening effort, and social. Through psychometric analysis, after removing locally dependent and misfitting items, all of the domains were found to have sound psychometric properties, with the exception of the independence domain. This resulted in a final CIQOL item bank of 81 items in 6 domains with good psychometric properties. Conclusion:Our findings reveal that hypothesis-driven quantitative analyses result in a psychometrically sound CIQOL item bank, organized into unique domains that are comprised of

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Evolving Trends in Cochlear Implantation: A Critical Look at the Older Population

Cited by 17 publications

References 15 publications

Geographic Variations in Medicare Cochlear Implantations in the United States

Geographic Variations in Medicare Cochlear Implantations in the United States

Trends in Cochlear Implantation in Texas: An Exploration of Outpatient Discharge Data, 2010 to 2017

Development of the Cochlear Implant Quality of Life Item Bank

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