Temporal analysis of hearing aids provision by the Brazilian Unified Health System

Fonsêca, Rodrigo Oliveira da; Dutra, Monique Ramos Paschoal; Ferreira, Maria Ângela Fernandes

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Original Article • CoDAS 33 (5) • 2021 • https://doi.org/10.1590/2317-1782/20202020201 copy

Temporal analysis of hearing aids provision by the Brazilian Unified Health System

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose

To analyze the outpatient production of aspects of hearing aids (HA) provision by the Brazilian Unified Health System (SUS) between 2005 and 2018.

Methods

This is an ecological time-series study, based on data from the Outpatient Information System of the SUS and the Brazilian Institute of Geography and Statistics. The HA provision rates were analyzed with Joinpoint software. Descriptive analyses were carried out for technological categories, funding, HA replacement and audiological monitoring.

Results

The South (9.96/10,000 inhabitants) and North (3.20/10,000 inhabitants) regions recorded the highest and lowest average rates, respectively. There were significant upward trends in HA provision in Brazil, in the North, Southeast and Midwest regions, with subsequent significant downward trends in the Southeast and Midwest. In the country, HA concession by technological categories was A (39.26%), B (36.93%) and C (23.81%), increasing funding. The Midwest (24.78%) and Northeast (14.22%) regions had the highest and lowest proportion of HA replacement, respectively. The audiological monitoring predominated in the Southeast (45.88%), with the lowest occurrence in the North (4.18%).

Conclusion

Between 2005 and 2018, trends fluctuated and discrepancies between geographic regions were observed in HA provision by the SUS, in addition to mismatches in the provision of technological categories and funding, a considerable proportion of replacements and insufficient audiological monitoring for HA users.

Keywords
Hearing; Hearing Loss; Hearing Aids; Unified Health System; Public Health Policy

Code and description – From 2007 onwards	Code and description – From 2008 onwards
3901105 – Follow-up of patients aged 3 years or younger with uni/bilateral HA	0301070032 – Follow-up of patient fitted with uni/bilateral HA
3901106 – Follow-up of patients between 3 and 15 years of age with uni/bilateral HA
3901107 – Follow-up of patients aged 15 years or older with uni/bilateral HA
3902101 – External behind-the-ear type A HA	0701030127 – External behind-the-ear type A HA
3902102 – External behind-the-ear type B HA	0701030135 – External behind-the-ear type B HA
3902103 – External behind-the-ear type C HA	0701030143 – External behind-the-ear type C HA
3902104 – External in-the-ear type A HA	0701030038 – External in-the-ear type A HA
3902105 – External in-the-ear type B HA	0701030046 – External in-the-ear type B HA
3902106 – External in-the-ear type C HA	0701030054 – External in-the-ear type C HA
3902107 – External in-the-canal type A HA	0701030062 – External in-the-canal type A HA
3902108 – External in-the-canal type B HA	0701030070 – External in-the-canal type B HA
3902109 – External in-the-canal type C HA	0701030089 – External in-the-canal type C HA
3902110 – External micro canal type A HA	0701030097 – External micro canal type A HA
3902111 – External micro canal type B HA	0701030100 – External micro canal type B HA
3902112 – External micro canal type C HA	0701030119 – External micro canal type C HA
3902113 – External conventional bone conduction type A HA	0701030011 – External conventional bone conduction type A HA
3902114 – Behind-the-ear external bone conduction type A HA	0701030020 – External behind-the-ear bone conduction type A HA
3902201 – External behind-the-ear type A replacement HA	0701030275 – External behind-the-ear type A replacement HA
3902202 – External behind-the-ear type B replacement HA	0701030283 – External behind-the-ear type B replacement HA
3902203 – External behind-the-ear type C replacement HA	0701030291 – External behind-the-ear type C replacement HA
3902204 – External in-the-ear type A replacement HA	0701030186 – External in-the-ear type A replacement HA
3902205 – External behind-the-ear type B replacement HA	0701030194 – External in-the-ear type B replacement HA
3902206 – External behind-the-ear type C replacement HA	0701030208 – External in-the-ear type C replacement HA
3902207 – External in-the-canal type A replacement HA	0701030216 – External in-the-canal type A replacement HA
3902208 – External in-the-canal type B replacement HA	0701030224 – External in-the-canal type B replacement HA
3902209 – External in-the-canal type C replacement HA	0701030232 – External in-the-canal type C replacement HA
3902210 – External micro canal type A replacement HA	0701030240 – External micro canal type A replacement HA
3902211 – External micro canal type B replacement HA	0701030259 – External micro canal type B replacement HA
3902212 – External micro canal type C replacement HA	0701030267 – External micro canal type C replacement HA
3902213 – External conventional bone conduction type A replacement HA	0701030160 – External conventional type A bone conduction replacement HA
3902214 – External behind-the-ear bone conduction type A replacement HA	0701030178 – External behind-the-ear type A bone conduction HA

Region	Average rate	APC1	95%CI	APC2	95%CI
North	3.20	29.1* (2005-2011)	15.7 to 44.1	5.1 (2011- 2018)	-3.7 to 14.6
Northeast	5.76	11.1 (2005-2008)	-2.3 to 26.4	0.0 (2008-2018)	-2.0 to 2.0
Southeast	8.87	8.5* (2005-2011)	4.7 to 12.3	-4.2* (2011-2018)	-6.8 to -11.5
South	9.96	3.3 (2005-2013)	-0.1 to 6.9	-0.8 (2013-2018)	-7.4 to 6.3
Midwest	8.36	32.0* (2005-2009)	22.8 to 41.8	-3.6* (2009-2018)	-5.6 to -1.6
Brazil	7.66	7.8* (2005-2011)	4.0 to 11.8	-2.6 (2011- 2018)	-5.3 to 0.3

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E-mail: revista@codas.org.br

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[1] Conflict of interests: Nothing to declare.