The cost-effectiveness of hearing-aid fitting in the Netherlands.
OBJECTIVE
To determine the cost-effectiveness of hearing-aid fitting.


METHODS
Cost-effectiveness analysis using a Markov model based on aggregate data and results from a prospective intervention study.


METHODS
The cost-effectiveness study was based in the general community. The prospective study was hospital based, as 85% of the first-time hearing-aid users attend a hospital in the process of hearing-aid fitting.


METHODS
The prospective intervention study included adult first-time hearing-aid users with no contraindications for hearing-aid use.


METHODS
The usual process of hearing-aid fitting in the Netherlands.


METHODS
Costs per quality-adjusted life-year (QALY). The QALYs were based on EuroQol scores. We included direct and indirect costs in the analysis.


RESULTS
The mean improvement on the EuroQol measure was 0.03 (95% confidence interval [CI], -0.03 to 0.08), and on the hearing-specific visual analog scale, 0.27 (95% CI, 0.22-0.31). The base-case outcome based on the EuroQol was 15 807/QALY (US dollars 17 072/QALY) (CI, -24 239/QALY to 3718/QALY).


CONCLUSIONS
On the basis of this base-case estimate, fitting of hearing aids is considered a cost-effective health care intervention. The CI indicates that the result is not unambiguously positive, probably because the EuroQol lacked sensitivity for the evaluation of hearing-aid fitting. Until now, no study has found an effect of hearing-aid fitting on generic quality of life. Therefore, measures are needed that are suitable for the evaluation of the effects of interventions for sensory disabilities, such as the fitting of hearing aids, on generic quality of life.
Joore
Manuela A
MA
Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, the Netherlands. Mjo@aozg.azm.nl
Van Der Stel
Hans
H
Peters
Hans J M
HJ
Boas
Gijs M
GM
Anteunis
Lucien J C
LJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005260:Female; D006310:Hearing Aids / Q000191:economics*; D006801:Humans; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D019057:Quality-Adjusted Life Years; D012680:Sensitivity and Specificity