Evidence map›Paper›PMID 37878655›Full record

ArticlePloS one2023

A country-wide health policy in Chile for deaf adults using cochlear implants: Analysis of health determinants and social impacts.

Mario Bustos-Rubilar, Fiona Kyle, Eliazar Luna, Kasim Allel, Ximena Hormazabal, Daniel Tapia-Mora, Merle Mahon

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.8field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 10 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Mario Bustos-RubilarDivision of Psychology and Language Science, University College London, London, United Kingdom.ORCID 0000-0002-0796-0202
Fiona KyleDivision of Psychology and Language Science, University College London, London, United Kingdom.
Eliazar LunaDepartment of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.
Kasim AllelInstitute for Global Health, University College London, London, United Kingdom.
Ximena HormazabalCarrera de Fonoaudiología, Departamento de Ciencias de la Salud, Pontificia Universidad Católica de Chile, Santiago, Chile.
Daniel Tapia-MoraDepartamento de Fonoaudiología, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Merle MahonDivision of Psychology and Language Science, University College London, London, United Kingdom.ORCID 0000-0001-9075-9739
University College London · GBPontificia Universidad Católica de Chile · CLUniversidad de Los Andes, Chile · CL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPost-lingual deafness represents a critical challenge for adults' well-being with substantial public health burdens. One treatment of choice has been cochlear implants (CI) for people with severe to profound hearing loss (HL). Since 2018, Chile has implemented a high-cost policy to cover CI treatment, the "Ley Ricarte Soto" (LRS) health policy. However, wide variability exists in the use of this device. To date, no related study has been published on policy evaluation in Chile or other Latin American countries.

objectivesThis study aimed to evaluate the impact of the LRS policy on the treatment success and labour market inclusion among deaf or hard of hearing (DHH) adults using CI. We examined and characterised outcomes based on self-reports about treatment success and occupation status between 2018 and 2020.

designWe performed a prospective study using hospital clinical records and an online questionnaire with 76 DHH adults aged >15 who had received CIs since the introduction of the LRS policy in 2018. Using univariate and multivariate regression models, we investigated the relationship between demographic, audiological, and social determinants of health and outcomes, including treatment success for social inclusion (International Outcome inventory for Hearing Aids and CIs assessment: IOI-HA) and occupation status for labour market inclusion.

resultsOur study showed elevated levels of treatment success in most of the seven sub-scores of the IOI-HA assessment. Similarly, around 70% of participants maintained or improved their occupations after receiving their CI. We found a significant positive association between treatment success and market inclusion. Participants diagnosed at younger ages had better results than older participants in both outcomes. Regarding social determinants of health, findings suggested participants with high social health insurance and a shorter commute time to the clinic had better results in treatment success. For labour market inclusion, participants with high education levels and better pre- CI occupation had better post-CI occupation status.

conclusionsIn evaluating the LRS policy for providing CIs for DHH adults in Chile, we found positive effects relating to treatment success and occupation status. Our study supports the importance of age at diagnosis and social determinants of health, which should be assessed by integrating public services and bringing them geographically closer to each beneficiary. Although evidence-based guidelines for candidate selection given by the LRS policy might contribute to good results, these guidelines could limit the policy access to people who do not meet the requirements of the guidelines due to social inequalities.

Indexed as

Cochlear ImplantationCochlear ImplantsDeafnessHearing LossAdultChileHealth PolicyHumansProspective StudiesSocial Change

Identifiers

PMID37878655
PMCPMC10599544
OpenAlexW4387950468

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.