# Cost-effective hearing aid delivery models: Outcomes, value, and candidacy

> **NIH NIH R01** · UNIVERSITY OF IOWA · 2020 · $323,904

## Abstract

PROJECT SUMMARY/ABSTRACT
 Age-related hearing loss is a substantial national problem due to its high prevalence and significant
psychosocial consequences. Although hearing aids (HAs) are the primary intervention for the management of
age-related hearing loss, only 15–30% of those who could benefit from HAs actually seek them out. HA
adoption rates are even worse for people with lower income and for racial and ethnic minorities. One of the
most commonly reported reasons for people not seeking HA intervention is the high cost of HAs and the
associated audiological fitting services. Because HAs fitted using the audiologist-based service-delivery model
(AUD model) are unaffordable, more and more Americans (1.5 million in 2010) purchase amplification devices
via over-the-counter service-delivery models (OTC models) to compensate for their impaired hearing.
 Although OTC amplification devices are gaining popularity and are regarded as an important option for
promoting accessible and affordable hearing healthcare, it is unclear if they are viable solutions for age-related
hearing loss as OTC models exclude professional services. Further, if there are outcome differences between
AUD and OTC models, it is unknown if the clinical improvement in outcomes will be offset by the improved
value (outcome relative to cost), or if it is possible to identify appropriate candidacy for each model to ensure
optimal patient care for all. Finally, no prior research has investigated if “hybrid” service-delivery models, in
which professionals provide streamlined services to fit OTC amplification devices, offer affordable and quality
amplification interventions as has been recently advocated. The overall goal of this project is to characterize the differential effect of service-delivery models on
provision of amplification so that accessible and affordable hearing healthcare can be facilitated. This project
proposes to conduct research that would provide new knowledge about the outcome, value, and candidacy
of OTC, hybrid, and AUD models and the effect of professional evaluation/selection services, patient-
centered services, and device-centered services on outcome and value. The proposed study will acquire
this knowledge through a two-site, double-blinded, randomized controlled field trial. The results obtained will
inform patients and hearing healthcare providers about what can be achieved with different service-delivery
models, and will help us develop guidelines to facilitate the selection of the most appropriate and cost-effective
intervention for a particular patient. The significance of the proposed project from the public health point of view
is that it will facilitate not only accessible and affordable, but also quality, hearing healthcare.

## Key facts

- **NIH application ID:** 9915882
- **Project number:** 5R01DC015997-03
- **Recipient organization:** UNIVERSITY OF IOWA
- **Principal Investigator:** Yu-Hsiang Wu
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $323,904
- **Award type:** 5
- **Project period:** 2018-05-08 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9915882

## Citation

> US National Institutes of Health, RePORTER application 9915882, Cost-effective hearing aid delivery models: Outcomes, value, and candidacy (5R01DC015997-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9915882. Licensed CC0.

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