Advances in Audiology, Las Vegas

Transcription

1 Advances in Audiology, Las Vegas Soren Hougaard, EHIMA 1

2 1. An overview of the surveyed markets 2. Hearing rehabilitation: Societal and personal benefits 3. Satisfaction with and reasons not to use hearing aids 2

3 1. An overview of the surveyed markets 3

4 Short interviews Long interviews Representative HA owners HA non-owners UK Germany (GER) France (FRA) Norway (NOR) Switzerland (CH) Italy (ITA) JapanTrak (JAP) Total EuroTrak and JapanTrak were designed and executed by 4

5 % self-reported hearing impaired (Base: population) Differences may be caused by: Age-gender-structure (=age pyramid) Awareness: Hearing tests, health care systems etc. Prevention / Work situation Other factors 12.5% 11.6% 10.9% 11.3% 9.4% 9.1% 8.8% 8.8% Germany Italy Japan France UK Norway Switzerland USA (MarkeTrak ) 5

6 Age group Age group Age group Age group Age group Age group older populations: <= 14 <= 14 Women: Unimpaired non-owner Women: Impaired non-user Women: HA owner Men: Unimpaired non-owner Men: Impaired non-user Men: HA owner Women: Unimpaired non-owner Women: Impaired non-user Women: HA owner Men: Unimpaired non-owner Men: Impaired non-user Men: HA owner <= 14 <= 14 <= 14 <= 14 Women: Unimpaired non-owner Women: Impaired non-user Women: HA owner Men: Unimpaired non-owner Men: Impaired non-user Men: HA owner Women: Unimpaired non-owner Women: Impaired non-user Women: HA owner Men: Unimpaired non-owner Men: Impaired non-user Men: HA owner Women: Unimpaired non-owner Women: Impaired non-user Women: HA owner Men: Unimpaired non-owner Men: Impaired non-user Men: HA owner Women: Unimpaired non-owner Women: Impaired non-user Women: HA owner Men: Unimpaired non-owner Men: Impaired non-user Men: HA owner 6

7 Adoption: Proportion of people with hearing aid (% of population) and adoption rate (% of stated impaired) Differences may be caused by: Health care system Reimbursement system / income structure Market development Culture Other factors. 42.5% 41.1% 38.8% 34.0% 30.4% 29.6% 24.6% 14.1% 3.7% 3.7% 3.4% 4.2% 2.8% 2.9% 1.5% 2.8% Norway UK Switzerland Germany France Italy Japan USA (MarkeTrak 2012 (% of population) 2012 (% of stated impaired) 2008) 7

8 % Binaural fitting Differences may be caused by: Health care system Reimbursement system / income structure Market development Professional attitude 76% 75% 74% 75% 76% 74% 63% 64% 60% 60% 61% 58% 59% 47% 44% 39% 36% Norway Switzerland Germany France UK Italy Japan 2012/ or earlier (EuroTrak 2009) 8

9 Do you have tinnitus (ringing or other noises in the ears or head) in one or both ears? No 67% 70% 71% 74% 74% 75% 80% Yes, sometimes 26% 25% 22% 20% 21% 20% 15% 3% 4% 2% 3% 4% 3% 4% 2% 2% 3% 2% 3% 2% 3% Italy Japan Germany Norway France UK Switzerland Yes permamently in both ears Yes permamently in one ear 9

10 Have you ever thought about a treatment of your tinnitus? Differences may be caused by: Health care system / income structure Culture etc. sometimes Tinnitus permanently Tinnitus 47% 48% 83% 81% 79% 75% 90% 40% 45% 12% 14% 13% 22% 13% 5% 7% 4% 8% 3% 2% 8% 16% 17% 31% 51% 43% 49% 52% 46% 49% 42% 13% 31% 36% 36% 36% 34% 27% 26% 39% 15% 12% Germany France Italy Japan Switzerland UK Norway I have never considered a treatment I have considered a treatment but did not have one I have / have had a treatment 10

11 Drop-out 1: not discussed with doctor Drop-out 2: Doctor did not recommend Drop-out 3: Not bought/received Hearing impaired Stated hearing impaired Discussed with ENT/GP Positive medical Advice Discussed with HA dispenser/au diologist Owner of a hearing aid 11

12 100% 90% 100% Drop out: 20% 80% 70% 60% 50% 40% 30% 20% 80% 48% Drop out: 40% 42% 38% 34% Impaired ENT/Doctor Recommend Owner Drop out: 29% 10% 0% All hearing impaired Discussed hearing loss with ear doctor and/or family doctor Positive medical advice (Ear doctor or family doctor recommend further action) Discussed hearing loss with HA dispenser/audiologist Positive advice HA dispenser/audiologist Bought hearing aid 12

13 100% 90% 100% Drop out: 20% 100% 90% 80% 70% 60% 50% 40% 30% 100% 76% Drop out: 24% 58% Drop out: 23% 51% Drop out: 27% 41% 43% 80% 70% 60% 50% 40% 30% 20% 10% 0% All hearing impaired 80% Discussed hearing loss with ear doctor and/or family doctor 48% Drop out: 40% Positive medical advice (Ear doctor or family doctor recommend further action) 42% Discussed hearing loss with HA dispenser/audiologist 38% 34% Impaired ENT/Doctor Recommend Owner Positive advice HA dispenser/audiologist Drop out: 29% Bought hearing aid 20% Impaired ENT/Doctor Recommend Owner 10% 0% All hearing impaired Discussed hearing loss with ear Positive medical advice (Ear doctor Discussed hearing loss with HA doctor and/or family doctor or family doctor recommend dispenser/audiologist further action) Positive advice HA dispenser/audiologist Bought hearing aid 100% 90% 80% 70% 100% 76% Drop out: 24% Drop out: 37% 60% 50% 40% 30% 20% 10% 48% 37% Drop out: 37% 34% 30% Impaired ENT/Doctor Recommend Owner 0% All hearing impaired Discussed hearing loss with ear Positive medical advice (Ear doctor Discussed hearing loss with HA doctor and/or family doctor or family doctor recommend dispenser/audiologist further action) Positive advice HA dispenser/audiologist Bought hearing aid 100% 90% 100% Drop out: 27% 80% 70% 60% 50% 40% 30% 20% 73% Drop out: 39% 44% 48% 39% 39% Impaired ENT/Doctor Recommend Owner Drop out: 13% 10% 0% All hearing impaired Discussed hearing loss with ear Positive medical advice (Ear doctor Discussed hearing loss with HA doctor and/or family doctor or family doctor recommend dispenser/audiologist further action) Positive advice HA dispenser/audiologist Bought hearing aid 13

14 OECD Data shows: 1. The density of practicing physicians is lower in the UK 2. People in the UK go to the doctors less often EuroTrak 2012 shows: People in the UK rarely take hearing tests Have you ever had your hearing tested? (Base:population) 37% 29% 56% 14% 24% 18% 31% 21% 40% 55% 53% 36% 21% 28% 15% 16% 22% 26% 30% 16% 17% 16% 19% 13% 13% 12% 12% 10% No, never Yes, more than 5 years ago Yes, in the last 1-5 years Yes, in the last 12 months Japan Germany Italy Switzerland Norway France UK 14

15 Recommendations by profession 85% 49% 38% 43% 37% 26% 14% 13% 15% GP ENT Audiologist (inc. NHS) Referred to an ear doctor (ENT) 73% 89% 44% 22% 31% 31% 9% 11% 11% GP ENT Audiologist Referred to a hearing aid dispenser / audiologist (incl. NHS) Recommended to get a hearing aid Recommended no 76% 90% further action 49% 38% 14% 13% 43% 37% 26% 85% 15% 19% 11% 12% 33% 37% 38% 10% G GP ENT Audiologist 15

16 Top 10 reasons for not having a hearing aid Cannot afford a hearing aid Cannot afford a hearing aid Ear doctors opinion (ENT) Have more serious priorities Hearing loss not severe enough They do not work well in noisy situations Hearing Aid Dispenser/Audiologists opinion They do not restore your hearing to normal Uncomfortable Family doctors opinion (GP) Hear well enough in most situations % 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Reason Somewhat a reason Not a reason 16

17 2. Hearing rehabilitation: Societal and personal benefits 17

18 How useful are your hearing aids on your job? Switzerland 10% 20% 70% France 5% 32% 63% Germany 8% 30% 62% Norway 14% 27% 59% Italy 10% 36% 54% UK 17% 33% 50% Japan 12% 46% 42% Of no use Of some use Of significant use N: UK 144/FRA 204/ GER

19 Countries are sorted by the average rather+strongly agree over the three questions Disagree strongly Rather disagree Neutral Rather agree Strongly agree I think that people with an untreated hearing loss tend to be less promoted in their job Germany Switzerland Italy UK France Japan Norway 9% 10% 8% 4% 3% 7% 6% 15% 12% 8% 8% 13% 14% 12% 35% 19% 34% 44% 44% 39% 39% 31% 41% 30% 25% 29% 25% 24% 19% 15% 16% 19% 16% 16% 11% I think that people with an untreated hearing loss tend not to get the job they deserve Germany Switzerland Italy UK France Japan Norway 8% 9% 7% 3% 7% 2% 7% 7% 11% 7% 12% 11% 12% 12% 31% 26% 35% 45% 45% 40% 35% 28% 39% 32% 25% 26% 25% 30% 26% 14% 16% 21% 19% 16% 12% I think that people with an untreated hearing loss tend to be under-salaried Germany Switzerland Italy UK France Japan Norway 11% 14% 9% 5% 4% 7% 10% 15% 11% 9% 9% 12% 15% 18% 37% 37% 47% 55% 36% 58% 43% 25% 27% 30% 25% 15% 15% 16% 16% 8% 13% 14% 17% 8% 7% Base: Hearing aid owners 19

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21 % of people with depression symptoms Hearing aid Top 50% hearing loss, no hearing aid Italy 32% 37% Depression symptoms: PHQ-2 Screening: In the last 2 weeks: Little interest or pleasure Feeling down, depressed, hopeless UK Germany Japan France 16% 19% 14% 17% 21% 27% 29% 41% Norway 9% 21% Switzerland 4% 11% Top 50% means six tiles 4-6 with a similar degree of hearing loss as hearing aid owners: Construction of 6-groups: A factor analysis was performed to identify one factor degree of hearing loss. The following questions were included in the factor: Number of ears impaired (one or two) Stated hearing loss (Mild to Profound) Scores on 6 APHAB-EC like questions (Scaled 1-5) When NOT using a hearing aid, how difficult is it for you to follow conversations in the presence of noise People were segmented into 6 groups of same size (16.67% of all hearing impaired in the sample). 21

22 % of people getting more forgetful Yes somewhat more Yes, much more JAP with hearing aid JAP no hearing aid (but sig. HL top 50%) ITA with hearing aid ITA no hearing aid (but sig. HL top 50%) 59% 61% 66% 66% 15% 19% 6% 13% Dementia symptom: Getting more forgetful in the last year? GER with hearing aid GER no hearing aid (but sig. HL top 50%) UK with hearing aid UK no hearing aid (but sig. HL top 50%) CH with hearing aid CH no hearing aid (but sig. HL top 50%) 57% 56% 56% 56% 63% 69% 4% 4% 2% 17% 7% 5% FRA with hearing aid FRA no hearing aid (but sig. HL top 50%) 54% 62% 3% 6% NOR with hearing aid NOR no hearing aid (but sig. HL top 50%) 42% 52% 3% 5% Base: Hearing aid owners and non owners with top 50% hearing loss Top 50% means six tiles 4-6 with a similar degree of hearing loss as hearing aid owners: Construction of 6-groups: A factor analysis was performed to identify one factor degree of hearing loss. The following questions were included in the factor: Number of ears impaired (one or two) Stated hearing loss (Mild to Profound) Scores on 6 APHAB-EC like questions (Scaled 1-5) When NOT using a hearing aid, how difficult is it for you to follow conversations in the presence of noise People were segmented into 6 groups of same size (16.67% of all hearing impaired in the sample). 22

23 Mentally and physically exhausted people. cost CHF 4.2 billions/year in Switzerland CH-Blick;

24 Rather agree Strongly agree In the evenings I often feel physically exhausted Hearing aid No hearing aid (but significant hearing loss top 50%) ITA UK GER JAP FRA NOR CH ITA UK GER JAP FRA NOR CH 29% 30% 26% 26% 25% 29% 38% 40% 37% 47% 44% 31% 32% 26% 16% 15% 11% 18% 8% 10% 18% 24% 15% 15% 26% 27% 15% 16% In the evenings I often feel mentally exhausted Hearing aid ITA UK GER JAP FRA NOR CH 23% 24% 23% 20% 17% 15% 35% 6% 6% 13% 11% 7% 10% 15% No hearing aid (but significant hearing loss top 50%) ITA UK GER JAP FRA NOR CH 38% 42% 35% 40% 22% 28% 25% 20% 14% 12% 14% 10% 25% 18% Top 50% means six tiles 4-6 with a similar degree of hearing loss as hearing aid owners: Construction of 6-groups: A factor analysis was performed to identify one factor degree of hearing loss. The following questions were included in the factor: Number of ears impaired (one or two) Stated hearing loss (Mild to Profound) Scores on 6 APHAB-EC like questions (Scaled 1-5) When NOT using a hearing aid, how difficult is it for you to follow conversations in the presence of noise People were segmented into 6 groups of same size (16.67% of all hearing impaired in the sample). 24

25 3. Satisfaction with and reasons not to use hearing aids 25

26 Overall satisfaction with HA % % satisfied Switzerland (n=514) % France (n=502) % Germany (n=500) % UK (n=501) % Norway (n=691) % Italy (n=510) % Japan (n=450) %! 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% very dissatisfied dissatisfied somewhat dissatisfied neutral somewhat satisfied satisfied very satisfied 26

27 Overall satisfaction with HA CH 2010 or after (n=270) CH 2009 or earlier (n=238) FRA 2010 or after (n=287) FRA 2009 or earlier (n=202) GER 2010 or after (n=236) GER 2009 or earlier (n=249) UK 2010 or after (n=295) UK 2009 or earlier (n=163) NOR 2010 or after (n=334) NOR 2009 or earlier (n=329) ITA 2010 or after (n=310) ITA 2009 or earlier (n=160) JAP 2010 or after (n=201) JAP 2009 or earlier (n=213) % 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% very dissatisfied dissatisfied somewhat dissatisfied neutral somewhat satisfied satisfied very satisfied 27

28 Overall satisfaction with HA CH HA worn up to 4 hrs/day (n=138) CH HA worn 4-8 hrs/day (n=115) CH HA worn more than 8 hrs/day (n=261) FRA HA worn up to 4 hrs/day (n=73) FRA HA worn 4-8 hrs/day (n=145) FRA HA worn more than 8 hrs/day (n=284) GER HA worn up to 4 hrs/day (n=135) GER HA worn 4-8 hrs/day (n=144) GER HA worn more than 8 hrs/day (n=221) UK HA worn up to 4 hrs/day (n=134) UK HA worn 4-8 hrs/day (n=131) UK HA worn more than 8 hrs/day (n=236) NOR HA worn up to 4 hrs/day (n=225) NOR HA worn 4-8 hrs/day (n=146) NOR HA worn more than 8 hrs/day (n=320) ITA HA worn up to 4 hrs/day (n=119) ITA HA worn 4-8 hrs/day (n=177) ITA HA worn more than 8 hrs/day (n=213) JAP HA worn up to 4 hrs/day (n=192) JAP HA worn 4-8 hrs/day (n=109) JAP HA worn more than 8 hrs/day (n=149) % 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% very dissatisfied dissatisfied somewhat dissatisfied neutral somewhat satisfied satisfied very satisfied 28

29 % better + a lot better Communicate more effectively Participate in group activities Sense of safety Social life Relationships at home FRA CH NOR GER ITA UK JAP 29

30 How did the following aspects change since person X is wearing hearing aids? % better +a lot better Communication with Person X Social activities together with Person X Personal relationship with Person X Quarrels/disputes with Person X FRA ITA GER CH UK NOR JAP 30

31 Bars represent importance within each country (individual scale size per country) Reasons % somewhat a reason + a reason ITA FRA GER UK NOR CH JAP Uncomfortable Hearing loss not severe enough Hear well enough in most situations They do not restore your hearing to normal They do not work well in noisy situations Have more serious priorities * * Would be embarrassed to wear a hearing aid 65 * * 41 Ear doctors opinion (ENT) * * * Bad design 65 * * 47 * * 37 Cannot afford a hearing aid * * * * Have tinnitus (ringing in ears) * * * * Hearing Aid Dispenser/Audiologists opinion * 61 * * * 46 * Do not admit I have a hearing loss in public 59 * * 46 * * * Family doctors opinion (GP) * 57 * * * 40 * Another hearing aid owners opinion * * 51 * * 40 * Have hearing loss only with high pitch sounds * * * * 38 * 40 Have not had hearing tested yet * * * 50 * * * Have hearing loss only with low frequency sounds * * * * * * 40 Sorted by overall importance * not within the Top10 reasons for this country Base: non owners Top 50% HL 31

32 Bars represent importance within each country (individual scale size per country) Reasons % somewhat a reason + a reason FRA CH NOR ITA UK GER JAP They do not restore your hearing to normal They do not work well in noisy situations Uncomfortable Have tried hearing aid and they do not work Hear well enough in most situations * Hearing loss not severe enough * Have hearing loss in only one ear 67 * 43 * Have hearing loss only with high pitch sounds * * Bad design * * * Do not admit I have a hearing loss in public * 55 * * * Would be embarrassed to wear a hearing aid * 50 * * Have tinnitus (ringing in ears) 61 * 34 * * * 36 Have more serious priorities * * * 49 * Have hearing loss only with low frequency sounds 65 * * * * * * Have Sensor-neural hearing loss (nerve deafness) * * * 53 * * * Social / Family opinion such as child, spouse, friend * * * 48 * * * I have vision or dexterity problems * * * 48 * * * Sorted by overall importance * not within the Top10 reasons for this country Owners who don t use, low sample sizes! 32

33 Non-owner: Think about the option to obtain / purchase a hearing aid. What do you think would influence you to obtain / purchase a hearing aid? CH Non- Owner (n=813) UK Non- Owner (n=795) FRA Non- Owner (n=809) GER Non- Owner (n=864) ITA Non- Owner (n=801) JAP Non- Owner (n=898) NOR Non- Owner (n=618) Influenceing factors non-owners Bars represent importance within each country (individual scale size per country) Hearing loss got worse 82% 69% 64% 74% 51% 65% 42% ENT/ Ear Doctor 51% 47% 53% 51% 51% 40% 33% GP /Family doctor 35% 58% 20% 23% 25% 32% 28% Spouse, relative, child, friend 47% 28% 26% 35% 16% 29% 30% Price of hearing aid 30% 32% 49% 28% 34% 21% 13% Free (Insurance, hearing aid free of charge) 35% 22% 42% 33% 18% 13% 17% Another hearing aid owner (word of mouth) 36% 25% 19% 17% 19% 13% 18% Hearing aid dispenser / Audiologist / Akustiker 38% 17% 22% 30% 26% 9% 27% Financial Situation improved 13% 15% 23% 22% 20% 8% * Safety concerns 19% * 17% 8% 18% 11% 10% Audiologist (NHS) * 38% * * * * Information/advice about hearing loss from consumer organisation or charity 13% * * * * * 10% Co-worker or boss 12% * * * * * * Hearing loss article or literature * * * * * 7% * Newspaper advertisement * * * * * 3% * Sorted by overall importance 33

34 We need to educate ENT doctors better We need to inform the hearing impaired better about reimbursement possibilities We should advocate adult screening programs (NB: diabetes!) We should educate politicians about the social cost issues (labor market, burn-outs, depression, dementia,) Channel more info to tinnitus patients re treatment options? 34

35 EHIMA Soeren Hougaard EHIMA secretary general Phone: (+45)

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37 GER UK FRA CH ITA NOR JAP 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Dispenser Listening situation Sound quality signal process. Product features %satisfied= % somewhat satisfied + % satisfied + % very satisfied HA-owners 37