Hearing and balance screening and referrals for Medicare patients: a national survey of primary care physicians.

Hearing and balance problems are prevalent among the elderly. Primary care physicians (PCPs) are important pivotal points of entry for ensuring that patients receive needed audiology services. New Medicare beneficiaries are entitled to one-time preventative examinations including hearing/balance screenings. A 35-item questionnaire was developed to assess physicians' participation in, knowledge about, and attitudes toward hearing/balance screenings and referrals for the elderly. The survey was mailed to 710 PCPs (19 undeliverable; 95 returned; response rate = 13.7%) in major metropolitan areas in the United States. Generally, these PCPs were not conducting hearing/balance screenings, aware of patient self-report screening questionnaires, or likely to screen in the future. They referred to audiologists and otolaryngologists mainly when patients complained of having hearing/balance difficulties, and they stated that these problems were important in the elderly and that the Medicare program was worthy of funding but that they had little time and were not reimbursed appropriately for screening. Therefore, PCPs could benefit from informational outreach campaigns on the prevalence of, negative HRQoL (health-related quality of life) effects from, and screening procedures for hearing/balance disorders in the elderly.

Use of a hearing and balance screening survey with local primary care physicians.

PURPOSE: This investigation is a follow-up to a national survey of hearing/balance screening and referrals in elderly patients by primary care physicians (PCPs). This local study focused on PCPs who actually treated elderly patients and could be contacted and followed in a single community. METHOD: PCPs in Santa Barbara, CA, were surveyed with a 35-item questionnaire via mailings, phone calls, and hand delivery to determine their participation in, knowledge of, and attitudes toward hearing/balance screening and referrals for the elderly. Potential respondents were 154 PCPs obtained from WebMD, Google, and telephone and provider directories for Santa Barbara. Of the 154 surveys mailed/delivered, 33 were returned undeliverable or unusable, and 32 were returned usable, producing an overall response rate of 26.5%. RESULTS: Results were similar to those of the national study; PCPs were unlikely to screen for hearing/balance problems unless patients complained. The PCPs were unaware of patient self-report screening methods and probably would not use them in the future. CONCLUSIONS: These PCPs acknowledged the importance of hearing/balance problems in the elderly, but their responses demonstrated insufficiencies in knowledge and potential attitudinal, time, and reimbursement obstacles that could interfere with their screening for hearing/balance problems. Audiologists should partner with PCPs to improve ways of meeting patients' needs but must consider resource/payoff implications for such endeavours.