Study of after hearing aid provision service and using for people with hearing loss under the universal health coverage

Among sensory impairment, hearing impairment is most found in the general population worldwide. WHO estimated in 2011 that more than 360 million people (5% of the world population) have disabling hearing loss. In the Thai population, the prevalence of hearing loss is 4%. Consequences of hearing impairment include inability to interpret speech sounds, often producing a reduced ability to communicate, delay in language acquisition, economic and educational disadvantage, social isolation and stigmatization, loneliness and frustration, particularly among older people who have hearing loss. Rehabilitation such as hearing aids improve the ability of hearing. It makes some sounds louder so that a person with hearing loss can listen, communicate, and participate more fully in daily activities. Hearing aids also improve the ability of hearing in quiet and noisy situations. In Thailand, hearing aids are provided to the hearing impaired according to conditions in health insurance schemes that they are registered to. However, there are issues of access to hearing aids provision such as seen in the small percentage of UHC patients, the largest health insurance scheme, of which only 16% have received the hearing aids. These issues mostly derive from service delivery system such as inadequacy of health personnel (audiologist) and inadequacy of health care units that can provide hearing aids especially ones in tertiary healthcare level. Moreover, hearing aids need to be imported with a high reimbursement rate of 13,500 baht/patient, much higher than other health related aids. Other problems also are found in after-service delivery. These problems include inadequacy of fixing units, time length it takes to fix a hearing aid, conflicts between patients’ demand and UHC reimbursement conditions. Problems derived from patients are also found. These include no follow up, not able to use the hearing aids, using wrong types of battery. Another important issue is all health insurance schemes do not reimburse the battery for hearing aids. While the battery is short-lived and costly.

These above problems may cause less opportunity to receive hearing aids in the future, thus resulting large economic loss. This study aims to examine how service is delivered to patients with disabling hearing loss after they have received hearing aids as well as estimate budget impact if the government needs to provide further benefits.