Catchment Profile of Large Cochlear Implant Centers in the United States. (September 2022)

• Record Type: Journal Article
• Authors: Nassiri, Ashley M.; Holcomb, Meredith A.; Perkins, Elizabeth L.; Bucker, Andrea L.; Prentiss, Sandra M.; Welch, Christopher M.; Andresen, Nick S.; Valenzuela, Carla V.; Wick, Cameron C.; Angeli, Simon I.; Sun, Daniel Q.; Bowditch, Stephen P.; Brown, Kevin D.; Zwolan, Teresa A.; Haynes, David S.; Saoji, Aniket A.; Carlson, Matthew L.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 167:Number 3(2022)
• Page Start: 545
• Page End: 551
• Publication Date: 2022-09
• Subjects: cochlear implant -- catchment area -- geographic -- access to care -- rural -- urban -- travel -- barriers to care; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/01945998211070993
• Languages: English
• ISSNs: 0194-5998

Abstract

Objective: To characterize the catchment area and patient profile of large cochlear implant (CI) centers in the United States. Study Design: Multi-institutional retrospective case series. Setting: Tertiary referral CI centers. Methods: Patients who underwent CI surgery at 7 participating CI centers between 2015 and 2020 were identified. Patients' residential zip codes were used to approximate travel distances and urban vs rural residential areas. Results: Over the 6-year study period (2015-2020), 6313 unique CI surgical procedures occurred (4529 adult, 1784 pediatric). Between 2015 and 2019, CI procedures increased by 43%. Patients traveled a median 52 miles (interquartile range, 21-110) each way; patients treated at rural CI centers traveled greater distances vs those treated at urban centers (72 vs 46 miles, P < .001). Rural residents represented 61% of the patient population and traveled farther than urban residents (73 vs 24 miles, P < .001). Overall, 91% of patients lived within a 200-mile radius of the institution, while 71% lived within a 100-mile radius. In adults, multiple regression analysis redemonstrated an association between greater travel distances and (1) older age at the time of CI and (2) residential rural setting (both P < .001, r 2 = 0.2). Conclusions: While large CI centers serve geographically dispersed populations, most patients reside within a 200-mile radius. Strategies to expand CI utilization may leverage remote programming, telemedicine, and strategic placement of new centers and satellite clinics to ameliorate travel burden.