Hearing loss and use of health services: a population-based cross-sectional study among Finnish older adults.
BACKGROUND
Older adults with hearing difficulties face problems of communication which may lead to underuse of health services. This study investigated the association of hearing loss and self-reported hearing difficulty with the use of health services and unmet health care needs in older adults.


METHODS
Data on persons aged 65 and older (n = 2144) drawn from a population-based study, Health 2000, were analyzed. Hearing loss was determined with screening audiometry (n = 1680). Structured face-to-face interviews were used to assess self-reported hearing difficulty (n = 1962), use of health services (physician and nurse visits, health examinations, mental health services, physical therapy, health promotion groups, vision test, hearing test, mammography, PSA test) and perceived unmet health care needs. Multivariable logistic regression analyses were used.


RESULTS
After adjusting for socio-economic and health-related confounders, persons with hearing loss (hearing level of better ear 0.5-2 kHz > 40 dB) were more likely to have used mental health services than those with non-impaired hearing (OR = 3.2, 95 % CI 1.3-7.9). Self-reported hearing difficulty was also associated with higher odds for mental health service use (OR = 2.1 95 % CI 1.2-3.5). Hearing was not associated with use of the other health services studied, except presenting for a hearing test. Persons with self-reported hearing difficulty were more likely to perceive unmet health care needs than those without hearing difficulty (OR = 1.7, 95 % CI 1.4-2.1).


CONCLUSIONS
Older adults with hearing loss or self-reported hearing difficulty are as likely to use most health services as those without hearing loss. However, self-reported hearing difficulty is associated with experiencing unmet health care needs. Adequate health services should be ensured for older adults with hearing difficulties.
Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, P.O. Box 35, Viveca, Jyvaskyla, 40014, Finland. tuija.m.mikkola@jyu.fi.|Folkhälsan Research Center, Helsinki, Finland. tuija.m.mikkola@jyu.fi.
Tuija M
TM
Mikkola
Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, P.O. Box 35, Viveca, Jyvaskyla, 40014, Finland.
Hannele
H
Polku
National Institute for Health and Welfare, Helsinki, Finland.
Päivi
P
Sainio
National Institute for Health and Welfare, Helsinki, Finland.
Päivikki
P
Koponen
National Institute for Health and Welfare, Helsinki, Finland.
Seppo
S
Koskinen
Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, P.O. Box 35, Viveca, Jyvaskyla, 40014, Finland.
Anne
A
Viljanen
D000368:Aged; D001301:Audiometry, Pure-Tone / Q000379:methods; D003144:Communication Barriers; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006296:Health Services / Q000145:classification / Q000706:statistics & numerical data; D006300:Health Services Misuse / Q000517:prevention & control / Q000706:statistics & numerical data; D034381:Hearing Loss / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D057566:Self Report
Aged; Aging; Health services; Health services needs and demand; Hearing loss; Pure-tone audiometry