PURPOSE
The Global HEAR Collaborative conducts research to fill gaps in the evidence on the epidemiology, treatment, and outcomes of hearing loss globally. By working together across countries, the Collaborative is uniquely equipped to identify effective strategies to eliminate disparities in hearing loss globally. Below is a selection of projects completed by the Global HEAR Collaborative to date.
COMPLETED COLLABORATIVE PROJECTS
GDP Matters: Cost Effectiveness of Cochlear Implantation and Deaf Education in Sub-Saharan Africa
Emmett SD et al. Otology Neurotology 2015;36:1357-65.
Cost effectiveness of pediatric cochlear implantation has been well established in the United States and Europe but is unknown in low resource settings, where access to the technology has traditionally been limited. With incidence of severe to profound congenital sensorineural hearing loss 5 to 6 times higher in low/middle-income countries than the US and Europe, developing cost-effective management strategies in these settings is critical. This study evaluated the cost effectiveness of cochlear implantation with mainstream education compared to deaf education with sign language in six countries in Sub-Saharan Africa. Cochlear implantation was cost effective in the lower- and upper-middle income economies of Nigeria and South Africa, and deaf education was cost effective in all countries investigated. While gross domestic product (GDP) strongly influenced cost effectiveness, the WHO threshold for cost effectiveness could still be reached in all countries, including emerging economies, using discounted device costs that varied directly with GDP.
Moving Beyond GDP: Cost Effectiveness of Cochlear Implantation and Deaf Education in Latin America
Emmett SD et al. Otology Neurotology 2016;37:1040-48.
Expanding on the prior work in Sub-Saharan Africa, cost effectiveness of cochlear implantation and deaf education were evaluated in seven countries in Latin America. Both cochlear implantation and deaf education were cost effective in all participating countries. Countries with high volume CI programs, such as Brazil and Colombia, had the most cost-effective programs with the lowest total implant costs, suggesting that improved negotiating capacity from higher volume of services may contribute to decreased costs. Gross domestic product (GDP) was less influential in this study, with participating countries representing higher levels of economic development overall than participants in the Sub-Saharan Africa study.
Expanding Access: Cost Effectiveness of Cochlear Implantation and Deaf Education in Asia
Emmett SD et al. Otolaryngolology – Head and Neck Surgery 2019. In Press.
This study expanded our series of cost effectiveness evaluations to include eight low- and lower-middle income countries in Asia. Cochlear implantation was cost effective in all countries except Nepal and Pakistan, and deaf education was cost effective in all countries except Nepal. Variation in CI maintenance and education-related costs may have contributed to the range of cost effectiveness observed in this study.
Emmett SD et al. Otology Neurotology 2015;36:1357-65.
Cost effectiveness of pediatric cochlear implantation has been well established in the United States and Europe but is unknown in low resource settings, where access to the technology has traditionally been limited. With incidence of severe to profound congenital sensorineural hearing loss 5 to 6 times higher in low/middle-income countries than the US and Europe, developing cost-effective management strategies in these settings is critical. This study evaluated the cost effectiveness of cochlear implantation with mainstream education compared to deaf education with sign language in six countries in Sub-Saharan Africa. Cochlear implantation was cost effective in the lower- and upper-middle income economies of Nigeria and South Africa, and deaf education was cost effective in all countries investigated. While gross domestic product (GDP) strongly influenced cost effectiveness, the WHO threshold for cost effectiveness could still be reached in all countries, including emerging economies, using discounted device costs that varied directly with GDP.
Moving Beyond GDP: Cost Effectiveness of Cochlear Implantation and Deaf Education in Latin America
Emmett SD et al. Otology Neurotology 2016;37:1040-48.
Expanding on the prior work in Sub-Saharan Africa, cost effectiveness of cochlear implantation and deaf education were evaluated in seven countries in Latin America. Both cochlear implantation and deaf education were cost effective in all participating countries. Countries with high volume CI programs, such as Brazil and Colombia, had the most cost-effective programs with the lowest total implant costs, suggesting that improved negotiating capacity from higher volume of services may contribute to decreased costs. Gross domestic product (GDP) was less influential in this study, with participating countries representing higher levels of economic development overall than participants in the Sub-Saharan Africa study.
Expanding Access: Cost Effectiveness of Cochlear Implantation and Deaf Education in Asia
Emmett SD et al. Otolaryngolology – Head and Neck Surgery 2019. In Press.
This study expanded our series of cost effectiveness evaluations to include eight low- and lower-middle income countries in Asia. Cochlear implantation was cost effective in all countries except Nepal and Pakistan, and deaf education was cost effective in all countries except Nepal. Variation in CI maintenance and education-related costs may have contributed to the range of cost effectiveness observed in this study.