title: Provision of hearing aids: does specialist assessment cause delay?
abstract: OBJECTIVE
  To identify the main delay in the provision of hearing aids for people with impaired hearing and identify possible problems and short-comings caused by a community based hearing aid dispensing service.
  
  
  METHODS
  Prospective cohort analysis based on data collected from patients on the duration of hearing impairment, from the referral letters in respect of the general practitioners' findings on otoscopy, and from the ear, nose, and throat assessment in the clinic with respect to the outcome of specialist otoscopy and management of the hearing impairment.
  
  
  METHODS
  General ear, nose, and throat outpatient clinic.
  
  
  METHODS
  100 Consecutive patients aged 19-94 referred by general practitioners for the provision of hearing aids or for assessment and treatment of impaired hearing.
  
  
  RESULTS
  Most patients with impaired hearing did not seek medical advice for at least a year. The time from referral by the general practitioner to the provision of a hearing aid was under two months. General practitioners consistently recognised normality on otoscopy but failed to recognise abnormality in eight of 45 cases. Seven patients required further investigation to exclude serious disease and nine had conditions amenable to surgery.
  
  
  CONCLUSIONS
  The main cause of delay in treating impaired hearing is failure by patients to seek help promptly. Specialist assessment of patients with impaired hearing is preferable and does not necessarily cause delay in providing hearing aids. The provision of hearing aids should remain a hospital based service.
authors.affiliation: Stobhill Hospital, Glasgow.
authors.forename: C
authors.initials: C
authors.lastname: Watson
authors.forename: J A
authors.initials: JA
authors.lastname: Crowther
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D012048:Correction of Hearing Impairment; D005194:Family Practice; D006310:Hearing Aids; D006311:Hearing Disorders / Q000175:diagnosis; D006801:Humans; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D012017:Referral and Consultation; D013997:Time Factors