A country-wide health policy in Chile for deaf adults using cochlear implants: Analysis of health determinants and social impacts

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dc.article.numbere0286592
dc.contributor.authorBustos-Rubilar M.
dc.contributor.authorKyle F.
dc.contributor.authorLuna E.
dc.contributor.authorAllel K.
dc.contributor.authorHormazabal X.
dc.contributor.authorTapia-Mora D.
dc.contributor.authorMahon M.
dc.date.accessioned2025-05-01T10:31:32Z
dc.date.available2025-05-01T10:31:32Z
dc.date.issued2023
dc.description.abstract© 2023 Bustos-Rubilar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Background Post-lingual deafness represents a critical challenge for adults’ well-being with substantial public health burdens. One treatment of choice has been cochlear implants (CI) for people with severe to profound hearing loss (HL). Since 2018, Chile has implemented a high-cost policy to cover CI treatment, the “Ley Ricarte Soto" (LRS) health policy. However, wide variability exists in the use of this device. To date, no related study has been published on policy evaluation in Chile or other Latin American countries. Objectives This study aimed to evaluate the impact of the LRS policy on the treatment success and labour market inclusion among deaf or hard of hearing (DHH) adults using CI. We examined and characterised outcomes based on self-reports about treatment success and occupation status between 2018 and 2020. Design We performed a prospective study using hospital clinical records and an online questionnaire with 76 DHH adults aged >15 who had received CIs since the introduction of the LRS policy in 2018. Using univariate and multivariate regression models, we investigated the relationship between demographic, audiological, and social determinants of health and outcomes, including treatment success for social inclusion (International Outcome inventory for Hearing Aids and CIs assessment: IOI-HA) and occupation status for labour market inclusion. Results Our study showed elevated levels of treatment success in most of the seven sub-scores of the IOI-HA assessment. Similarly, around 70% of participants maintained or improved their occupations after receiving their CI. We found a significant positive association between treatment success and market inclusion. Participants diagnosed at younger ages had better results than older participants in both outcomes. Regarding social determinants of health, findings suggested participants with high social health insurance and a shorter commute time to the clinic had better results in treatment success. For labour market inclusion, participants with high education levels and better pre- CI occupation had better post-CI occupation status. Conclusions In evaluating the LRS policy for providing CIs for DHH adults in Chile, we found positive effects relating to treatment success and occupation status. Our study supports the importance of age at diagnosis and social determinants of health, which should be assessed by integrating public services and bringing them geographically closer to each beneficiary. Although evidence-based guidelines for candidate selection given by the LRS policy might contribute to good results, these guidelines could limit the policy access to people who do not meet the requirements of the guidelines due to social inequalities.
dc.description.funderOverton and Jeannette Smith Fund
dc.description.funderNational Institutes of Health
dc.format.extent8 páginas
dc.fuente.origenScopus
dc.identifier.doi10.1371/journal.pone.0286592
dc.identifier.eisbn978-1-5106-5352-8
dc.identifier.eissn2641-435X
dc.identifier.isbn978-1-5106-5351-1
dc.identifier.issn19326203
dc.identifier.pubmedid40243597
dc.identifier.scieloidS0718-69242020000300109
dc.identifier.scopusidSCOPUS_ID:85175218561
dc.identifier.urihttps://doi.org/10.1371/journal.pone.0286592
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/103770
dc.identifier.wosidWOS:001085270200001
dc.information.autorucDepartamento de Ciencias de la Salud; Hormazabal Reed Ximena Alejandra; S/I; 1205392
dc.issue.numero3
dc.language.isoen
dc.nota.accesoContenido completo
dc.pagina.final36
dc.pagina.inicio29
dc.publisherSpringer International Publishing
dc.relation.ispartofWorld Conference on Timber Engineering (2023 : Oslo, Noruega)
dc.revistaPLoS ONE
dc.rightsacceso abierto
dc.subjectLow-rise Buildings
dc.subjectReinforced Concrete
dc.subjectReinforcing Bars
dc.subjectSeismic Performance1
dc.subjectThin Walls
dc.subjectWelded Mesh
dc.subject.ddc600
dc.subject.deweyTecnologíaes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleA country-wide health policy in Chile for deaf adults using cochlear implants: Analysis of health determinants and social impacts
dc.typeartículo
dc.volumen18
sipa.codpersvinculados1205392
sipa.indexScopus
sipa.trazabilidadCarga WOS-SCOPUS;01-05-2025
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