Long-term cost implications for cochlear implant recipients

[摘要] ENGLISH ABSTRACT: Cochlear implantation is an expensive but cost-effective intervention which must be used forlife. It can provide individuals with severe-to-profound hearing loss improved soundperception in comparison to that obtained using hearing aids. In South Africa implants are notstate subsidised, and related costs need to be covered by implant recipients. Cochlearimplant teams thus need to ensure that individuals, who are selected, will benefit from thedevice and will be able to use it for their lifetime. Implantees should know the immediate andpotential future costs involved, to be able to decide on its affordability.The primary aim of this study was to determine the immediate and long-term costs of cochlearimplantation. One hundred and fifty four implant recipients from the Tygerberg Hospital-University of Stellenbosch Cochlear Implant Unit in Cape Town, South Africa were surveyed.Costs were categorized according to the time period post implantation and were converted toConstant Rands (June 2010) using the Consumer Price Index to allow for comparison in realterms over time.In the first 10 years of implantation the average estimated costs incurred by adult implanteestotalled R379 626, and children R455 225. The findings showed that the initial purchase of theimplant system was the most substantial cost involved (currently R221 000). Upgrading thespeech processor, which on the average took place every 7 years, was the second highestcost subjects encountered (currently R85 000). The cost of spares (on average R276 peryear) and repairs (R3000 per repair) increased with duration of use. Battery costs rangedbetween R1200 and R3372 per year and insurance costs averaged R4040 per year.Most appointments took place in the first two years following implantation. Average travelcosts during the first two years were R1024 for those within 50km of the implant unit andR8645 for those living more than 1000km away. Accommodation costs for non-localrecipients, peaked during this period (on average R3390). Additional rehabilitation services forpaediatric implantees cost an estimated R37 159 in the first five years after implantation.Subjects advised potential implantees to save, budget and plan for the high costs involved inimplantation, as well as to join a medical aid which could assist with the costs involved. The findings of the study hold great relevance for both implantees and cochlear implantprofessionals. Careful consideration of the financial implications of cochlear implantation iscritically important in the South African context to ensure that recipients are successful longtermcochlear implant users. Although the actual costs in the study were related to the oneimplant system used at Tygerberg Hospital-University of Stellenbosch Cochlear Implant Unit,it is believed that the types and amounts of costs involved hold relevance for all individualsimplanted in South Africa.

[发布机构] Stellenbosch University