How Did the COVID-19 Pandemic Affect Cochlear Implantation Rates and Costs in Children?
Cochlear implantation (CI) is a mainstay in the treatment of severe sensorineural hearing loss (SNHL). CI provides prelingually deaf children with the opportunity to develop speech and language skills and gives postlingually deaf patients the ability to hear again. In a retrospective cohort study using the Pediatric Health Information System® (PHIS) database, compiled from 50 U.S. children’s hospitals, Zhen “Jane” Huang, MD, MBA, CPO, an assistant professor in the Department of Otorhinolaryngology at McGovern Medical School at UTHealth Houston, sought to determine if the COVID-19 pandemic affected CI procedure frequency and cost. Working with her on the study was postgraduate year 4 resident David Z. Allen, MD.
“There is significant evidence that early cochlear implantation for children with SNHL improves auditory skills, speech development outcomes, and social skills, and it can be performed safely,” Dr. Huang says. “The pandemic had a significant impact on health care volumes and particularly surgical volumes. It has been demonstrated in the literature that otolaryngology procedures saw a substantial decrease, so we wanted to investigate how cochlear implantation was affected.”
Dr. Huang and Dr. Allen found that during the years from 2016 through 2021, the number of CIs performed rose every year except 2020, when there was a decrease driven largely by the southern and midwestern regions of the U.S. “The number of CIs in 2020 was lower than in 2019 or 2021,” she says. “The range of charge-to-cost ratios was larger in 2021, suggesting cost shifting by some hospitals to offset the loss in revenue. There was a small but significant increase in white, non-Hispanic patients receiving CI in 2020 and 2021, which suggests a socio-economic shift in care post-pandemic.”
“It was surprising to me that the pandemic affected CI to that degree, especially after the hospital lockdown ended, because hearing is so important to a child’s development,” she adds.
As a PHIS-certified advanced reporter, Dr. Huang can access the PHIS database to create her own reports. She also holds a subcertification in complex pediatric otolaryngology from the American Board Otolaryngology-Head and Neck Surgery. She presented this research as a poster at the American Society of Pediatric Otolaryngology spring annual meeting held in Boston.