title: Patient preferences for direct hearing aid provision by a private dispenser. A discrete choice experiment.
abstract: OBJECTIVE
  Our objective was to elicit patient preferences for transferring elements of hearing aid provision from the medical sector [Ear Nose and Throat (ENT) specialists and audiological centers] to private hearing aid dispensers, and to understand the trade-offs between different elements of hearing aid provision.
  
  
  METHODS
  A discrete choice experiment was administered from 150 hearing-impaired persons in the Netherlands. Mean age was 71 (range 18-95) and 57% were male.
  
  
  RESULTS
  Participants preferred the initial assessment at the dispenser, higher accuracy in identifying persons in need of medical care, shorter duration of the total hearing aid provision, and a follow-up at the ENT specialist. They required compensation of at least euro 17 per 2 mo extra duration, euro 54 for an initial assessment at the ENT specialist, euro 119 per 10% decrease in accuracy, and euro 227 to forgo the follow-up at the ENT specialist. Preferences were influenced by sex, age, educational level, and experience with hearing aid provision.
  
  
  CONCLUSIONS
  Hearing-impaired persons are receptive to transferring elements of hearing aid provision from the medical sector to private dispensers. Although safety and efficiency issues should also be considered, from the present study we can conclude that in the organization of hearing aid provision hearing-impaired persons prefer an initial assessment at a private dispenser when the dispenser is at least 95% as accurate as the ENT specialist, and prefer a follow-up visit at the ENT specialist.
authors.affiliation: Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, Maastricht, the Netherlands. Janneke.grutters@maastro.nl
authors.forename: Janneke P C
authors.initials: JP
authors.lastname: Grutters
authors.forename: Manuela A
authors.initials: MA
authors.lastname: Joore
authors.forename: Alfons G H
authors.initials: AG
authors.lastname: Kessels
authors.forename: Adrian C
authors.initials: AC
authors.lastname: Davis
authors.forename: Lucien J C
authors.initials: LJ
authors.lastname: Anteunis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001298:Audiology; D002755:Choice Behavior; D003362:Cost-Benefit Analysis; D005260:Female; D006310:Hearing Aids / Q000191:economics; D006319:Hearing Loss, Sensorineural / Q000191:economics / Q000523:psychology / Q000534:rehabilitation*; D006320:Hearing Tests / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010036:Otolaryngology; D010342:Patient Acceptance of Health Care; D011304:Presbycusis / Q000191:economics / Q000503:physiopathology / Q000534:rehabilitation*; D017149:Private Sector; D012017:Referral and Consultation / Q000191:economics