JOURNAL OF AGING AND HEALTH / August 2001 Green, Pope / HEARING IMPAIRMENT AND HEALTH CARE Effects of Hearing Impairment on Use of Health Services Among the Elderly

Objectives: To assess the effects of hearing impairment on health-service use in an elderly population, controlling for factors associated with hearing difficulties known to affect utilization. Methods: Diagnoses of hearing impairment, depression, and chronic illnesses were used in hierarchical regression procedures to predict the vol-ume and probability of any service use among 1,436 randomly selected 65-year-old health maintenance organization members. Results: Hearing impairment substan-tially increased the likelihood of making at least one visit to a health care provider (OR = 3.31, 95%; CI = 1.55-7.06). Among those who made such visits, however, hear-ing impairment did not lead to use of additional services despite expectations to the contrary. Discussion: Further research should explore whether underutilization of services exists, and, if so, whether it stems from clinician or patient attitudes about the seriousness of hearing impairment, from a paucity of available treatment strategies, or from some combination of these and other factors. In the United States, hearing impairment is one of the most prevalent chronic conditions among the elderly (U.S. Department of Health and Human Services, 1995). It adversely affects quality of life (Mulrow et al., 1990) and physical and psychosocial functioning (Bess