PATIENT SATISFACTION

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PATIENT SATISFACTION

• Jerry L. Northern, Ph.D.
• HEARx LTD,
• West Palm Beach, FL
• USA

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1998 US Hearing Instrument Market

• 27.2 Million Hearing-Impaired Persons
• 5.6 Million Hearing Aid Users
• Market Penetration?
• 1984 23.8
• 1999 20.4

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World Senior Citizens

• 20 Population Will Be gt 65 yrs
• Italy 2003
• Japan 2005
• Germany 2006
• U.K. 2016
• France 2016
• Canada 2021
• USA 2023

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Common Excuses for Not Purchasing Sergei
Kochkin, 1994

• Dont perform well in noise
• Too much feedback (squeal)
• Dont work well
• Poor sound quality
• Break down too often
• Dont work with telephones
• Negative experience of friends

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Hearing Aid Selection

• Real Ear Measurement
• Prescriptive Formula Targeting
• Compression Circuitry
• Advanced Technologies

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Hearing Aid Fitting

• Software-based Fitting Assistance
• Programmable
• Multiple Channels
• Multiple Memories
• Noise Reduction Technologies

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Satisfaction with High-Performance Hearing Aids

• Mail survey to 5000 subjects
• APHAB - 24 questions
• MarkeTrak Satisfaction Survey
• 34 questions
• 13 instrument samples
• Advanced hearing instrument features

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MarkeTrak Conclusions

• Multiple superior to single features
• Multiple memories
• Multiple microphones
• Digital programmables
• CIC rated high
• Impressive customer satisfaction achieved with
  advanced hearing instruments!

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Understanding Speech in Noise

• Wide Bandwidth
• Binaural Fitting
• Low Distortion
• Variable Release Compression
• Directional Microphones
• CICs

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APHAB

• Abbreviated Performance of Hearing Aid Benefit
• Pre Post Fitting Self-Questionnaire
• 24 Multiple-Choice Questions
• Background Noise (BN)
• Reverberant Environment (RV)
• Ease of Communication (EC)
• Aversiveness to Sound (AV)

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HHIE

• Hearing Handicap Inventory for the Elderly
• Pre Post Fitting Self-Questionnaire
• 25 Multiple-Choice Questions
• Social Situations
• Emotional Situations

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COSI

• Client Oriented Satisfaction Inventory
• Pre Post Self Report Items
• Open-ended
• Usually limited to 5 items
• Difficult to score
• Patient is own reference point

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Satisfaction Cards

• How satisfied are you with your new hearing aids?
• Do your aids help you to communicate better with
  family and friends?
• Do your aids help you to hear the TV more
  clearly?
• Do your aids help you to hear better at the
  movies?
• Do your aids help you to hear better in noisy
  situations?

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Satisfaction Cards Results

• N2,317 patients (1998)
• Talk with Family Friends (87)
• Television (85)
• Movies/Theater (77)
• Noisy Situations (650
• General Satisfaction (83)

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Mail Survey

• Computer scored
• 10-12 Questions
• 3 Versions of mail survey
• Need, but no purchase
• Ordered -- but cancelled
• Hearing Aid Returned
• Free Gift-Audio Music Cassette

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Mail Survey Questionnaire

• I prefer a different hearing aid
• Price of the H.A. was too expensive
• I did not like the audiologist
• I dont think H.A.s will help me
• I dont want to use hearing aids
• My insurance referred me to another

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Mail Survey Questionnaire

• I dont think I need hearing aids
• The hearing aids are uncomfortable
• The office location is inconvenient
• I already have hearing aids
• I bought hearing aids elsewhere
• No confidence in the staff

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Why did you return your hearing aids?

• Did not help (49)
• Too expensive (25)
• Uncomfortable (38)
• Did not work properly (16)
• Too loud, too noisy (18)

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Why did you decide not to buy hearing aids?

• Too expensive (60)
• Dont think I need them (9)
• Bought elsewhere (11)
• Uncomfortable (7)

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HEARx Telephone Survey

• Used 9 questions
• 6-month follow-up survey
• Did your health plan pay for your H.A.s?
• Did you attend the free H.E.L.P. classes?
• 5-point answer scale
• Always-Most of time-Sometimes-Rarely-Never
• Very expensive time consuming!

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ANALYSIS of HA RETURNS

• Reviewed 8,372 patient records
• 634 (7.3) returned at least one HA
• Degree of hearing loss
• Age and gender
• Prior use
• Style
• Technology

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Aural Rehabilitation

• Auditory training
• Recognition of environmental noises
• Word discrimination in adverse conditions
• Recognition of specific phonetic elements in
  speech

R. Carhart, 1947
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Aural Rehabilitation

• Effective listening habits
• Coping strategies
• Non-verbal and situational clues
• Meaning of the message?
• Improve communication efficiency

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Patient Education HA Returns

• 7,178 patient records reviewed
• No H.E.L.P. Classes
• 4,107 (57)
• 378 (9) Returned
• H.E.L.P. Classes
• 3,080 (43)
• 102 (3) Returned

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Pre Post Assessment

• One on one conversation
• TV/Radio
• Movies, theater
• Car
• Small groups
• Doorbell ring

• Large Groups
• Restaurants
• Telephone conversation
• Telephone ring
• Social uncomfortable
• Loss noticed by others

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Patient Dissatisfaction?

• 5 of all hearing aids -
• Never Used!
• 20 of all hearing aids -
• In the drawer!
• 50 of all hearing aids -
• Used lt half-time!

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Increasing Patient Satisfaction

• Hearing-Impaired Patients
• More inquisitive
• More educated
• More sophisticated
• More demanding
• Higher expectations
• Increase our knowledge skills
• Include the patient in decisions

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Achieving Patient Satisfaction

• 1. Advanced technology!
• 2. Aural rehabilitation!

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Satisfaction Benefits

• Reduced return rate
• Increased referrals
• Free advertising
• Fewer follow-up visits
• Satisfied hearing aid users
• HAPPY PEOPLE!

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Listening Packet

• Using Your New Hearing Aids
• Components of Hearing Loss
• Listening Strategies
• Communication Guidelines
• Realistic Expectations
• Hearing Aid Maintenance
• Hearing in Background Noise
• Assistive Listening Devices