Pediatrics (P)
Madeline K. Brimmer, BA (she/her/hers)
The Ohio State University
Upper Arlington, Ohio
Financial Disclosures: I do not have any relevant financial relationships with anything to disclose.
Non-Financial Disclosures: I do not have any relevant non-financial relationships with anything to disclose.
Julie L. Hazelbaker, PhD (she/her/hers)
Clinical Assistant Professor
The Ohio State University
The Ohio State University
Columbus, Ohio
Financial Disclosures: I do not have any relevant financial relationships with anything to disclose.
Non-Financial Disclosures: I do not have any relevant non-financial relationships with anything to disclose.
Ursula M. Findlen, PhD
Director of Audiology Research
Nationwide Children's Hospital
The Ohio State University
Columbus, Ohio
Financial Disclosures: I do not have any relevant financial relationships with anything to disclose.
Non-Financial Disclosures: I do not have any relevant non-financial relationships with anything to disclose.
This retrospective study evaluated various socioeconomic factors which have an impact on audiologic follow-up following a referred newborn hearing screening. Between 2018 and 2021, more than 2000 newborn patients were referred to our facility for evaluations due to risk of hearing loss. Approximately 88% of these patients received evaluations with a mean age of diagnosis being 74 days, which falls within the EDHI 1-3-6 guidelines. This study addresses which factors have the greatest impact on a patient’s chance of being lost to follow-up, such as race and ethnicity, insurance status, and the zip code in which the patient resides.
Summary: Although the national benchmark for Early Hearing Detection and Intervention (EHDI) has been to complete screening by 1 month, diagnosis by 3 months, and early intervention by 6 months for over two decades, multiple barriers exist that hinder families from effectively moving through the EHDI process. This retrospective study evaluated various socioeconomic factors which have an impact on EHDI in the state of Ohio. Between 2018 and 2021, more than 2,000 newborn patients were referred to our facility for evaluations due to the risk of hearing loss; 76% of which received a diagnosis within 3 months of birth. An additional 12% of newborns received a diagnosis by the age of six months, and the final 12% were loss-to-follow-up (LTFU). This study was completed to identify family and system-level barriers which affect the facilitation of EHDI in the central Ohio area.
Known barriers to the completion of diagnostic assessments include age at referral, age at first diagnostic test, whether middle ear involvement was present, race/ethnicity, type of insurance, and the access families have to follow-up centers based on geographical location. The extent to which these factors influenced loss to follow-up was examined in our cohort based on whether the diagnosis occurred on time (by 3 months), delayed (by 6 months), or not at all (LTFU). Overall, age at referral was relatively later for infants who were delayed or LTFU. A larger proportion of infants who had delayed diagnosis experienced middle ear involvement (76%) when compared to those who were diagnosed on time (14%). When examining race/ethnicity, families who identified as non-Hispanic black or bi/multi-racial were more often delayed in diagnosis or LTFU. Lastly, infants with public insurance more often experienced delayed diagnosis or LTFU than infants with private insurance or self-pay, while infants on private insurance were less likely to be LTFU for diagnosis.
This retrospective study provides information regarding the socioeconomic factors which affect loss to follow-up rates in the EHDI program in the central Ohio area. Knowing which populations are most at risk to be lost to follow-up and what barriers prevent appointment completion can help create targeted interventions to facilitate the EHDI process, which in turn will help maximize outcomes in children who are deaf or hard of hearing. Potential interventions and outcomes of implementation will be discussed.