Hospital service utilisation and treatment costs before and after cochlear implantation in adults with hearing loss: a retrospective cohort study

Objective: Hearing loss can lead to a higher health service use which may be reduced by using hearing technology. This study aimed to examine pre- and post-cochlear implant hospital service use and treatment costs of adults with hearing loss. Methods: A retrospective cohort study was conducted using linked hospital admission and mortality data in New South Wales, Australia. Adults aged ≥18 years who received a cochlear implant between 2015- and 2017 were included. Outcomes included all-cause hospital admissions, total hospital length of stay (LOS) and treatment costs in 4 years prior to- and 4 years post-implant. A negative binomial regression model was used to examine characteristics associated with hospitalisation. Results: There were 1159 individuals who received a cochlear implant between 2015- and 2017. Adults aged ≥65 years had a higher number of all-cause hospitalisations post-implant (65.7%) compared with pre-implant (57.9%). The median hospital LOS was 5.0 days (IQR 13.0) pre- and 6.0 days (IQR 19.0) post-implant. Being of aged ≥65 years, having comorbidity and a fall-related injury were associated with both pre- and post-implant hospitalisations. Having a mental health disorder was additionally associated with pre-implant hospitalisations. The median treatment costs were AUD$10,790 (IQR 27,595) pre- and AUD$9,444 (IQR 31,945) post-implant. Conclusion: Adults aged ≥65 years, with comorbidities, fall-related injuries and mental health disorders faced higher hospitalisation. Adults encountered higher treatment costs pre-implantation, but these costs decreased post-implant. This suggests a need for tailored pre- and post-operative care strategies to mitigate risks and manage costs effectively.