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Research ArticleOriginal Research

The Association of Hearing Loss with Hospitalization

Philip Zazove, Melissa A. Plegue, Elie Mulhem, Kate Panzer, Samantha Ratakonda, Ananda Sen, Jenna Greenberg, Anna McEvoy, Paul R. Kileny and Michael M. McKee
The Journal of the American Board of Family Medicine May 2023, jabfm.2022.220407R1; DOI: https://doi.org/10.3122/jabfm.2022.220407R1
Philip Zazove
From the Department of Family Medicine, University of Michigan, Ann Arbor, Michigan (PZ, MAP, KP, SR, JG, AM, MMM); Department of Family Medicine and Community Health, Oakland University William Beaumont School of Medicine, Rochester, Michigan (EM); Department of Otorhinolaryngology, University of Michigan, Ann Arbor, Michigan (PRK)
MD
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Melissa A. Plegue
From the Department of Family Medicine, University of Michigan, Ann Arbor, Michigan (PZ, MAP, KP, SR, JG, AM, MMM); Department of Family Medicine and Community Health, Oakland University William Beaumont School of Medicine, Rochester, Michigan (EM); Department of Otorhinolaryngology, University of Michigan, Ann Arbor, Michigan (PRK)
MA
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Elie Mulhem
From the Department of Family Medicine, University of Michigan, Ann Arbor, Michigan (PZ, MAP, KP, SR, JG, AM, MMM); Department of Family Medicine and Community Health, Oakland University William Beaumont School of Medicine, Rochester, Michigan (EM); Department of Otorhinolaryngology, University of Michigan, Ann Arbor, Michigan (PRK)
MD
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Kate Panzer
From the Department of Family Medicine, University of Michigan, Ann Arbor, Michigan (PZ, MAP, KP, SR, JG, AM, MMM); Department of Family Medicine and Community Health, Oakland University William Beaumont School of Medicine, Rochester, Michigan (EM); Department of Otorhinolaryngology, University of Michigan, Ann Arbor, Michigan (PRK)
BSA
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Samantha Ratakonda
From the Department of Family Medicine, University of Michigan, Ann Arbor, Michigan (PZ, MAP, KP, SR, JG, AM, MMM); Department of Family Medicine and Community Health, Oakland University William Beaumont School of Medicine, Rochester, Michigan (EM); Department of Otorhinolaryngology, University of Michigan, Ann Arbor, Michigan (PRK)
MS
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Ananda Sen
From the Department of Family Medicine, University of Michigan, Ann Arbor, Michigan (PZ, MAP, KP, SR, JG, AM, MMM); Department of Family Medicine and Community Health, Oakland University William Beaumont School of Medicine, Rochester, Michigan (EM); Department of Otorhinolaryngology, University of Michigan, Ann Arbor, Michigan (PRK)
PhD
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Jenna Greenberg
From the Department of Family Medicine, University of Michigan, Ann Arbor, Michigan (PZ, MAP, KP, SR, JG, AM, MMM); Department of Family Medicine and Community Health, Oakland University William Beaumont School of Medicine, Rochester, Michigan (EM); Department of Otorhinolaryngology, University of Michigan, Ann Arbor, Michigan (PRK)
MD
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Anna McEvoy
From the Department of Family Medicine, University of Michigan, Ann Arbor, Michigan (PZ, MAP, KP, SR, JG, AM, MMM); Department of Family Medicine and Community Health, Oakland University William Beaumont School of Medicine, Rochester, Michigan (EM); Department of Otorhinolaryngology, University of Michigan, Ann Arbor, Michigan (PRK)
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Paul R. Kileny
From the Department of Family Medicine, University of Michigan, Ann Arbor, Michigan (PZ, MAP, KP, SR, JG, AM, MMM); Department of Family Medicine and Community Health, Oakland University William Beaumont School of Medicine, Rochester, Michigan (EM); Department of Otorhinolaryngology, University of Michigan, Ann Arbor, Michigan (PRK)
PhD
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Michael M. McKee
From the Department of Family Medicine, University of Michigan, Ann Arbor, Michigan (PZ, MAP, KP, SR, JG, AM, MMM); Department of Family Medicine and Community Health, Oakland University William Beaumont School of Medicine, Rochester, Michigan (EM); Department of Otorhinolaryngology, University of Michigan, Ann Arbor, Michigan (PRK)
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Article Figures & Data

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    Figure 1.

    Questions asked of subjects.

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    Figure 2.

    Cumulative hazard readmission. Abbreviation: HL, Hearing Loss.

Tables

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    Table 1.

    Patient Characteristics

    Hearing Loss (HL)
    No HLMild HLModerate+ HL
    n = 289n = 630n = 328P-Value
    Age, mean (S.D.)63.61(S.D. = 6.14)69.78(S.D. = 8.37)77.28(S.D. = 8.68)P < .001
    Age Group
    55 to 64172(60%)175(28%)28(9%)P < .001
    65 to 74103(36%)266(42%)86(26%)
    75 to 8413(4%)153(24%)135(41%)
    85+1(0%)36(6%)79(24%)
    Gender
    Female164(57%)277(44%)132(40%)P < .001
    Male125(43%)353(56%)196(60%)
    Race
    White241(83%)568(90%)303(92%)P = .003
    Black35(12%)42(7%)16(5%)
    Other8(3%)16(3%)9(3%)
    Missing5(2%)4(1%)
    Not Hispanic273(94%)618(98%)325(99%)P = .002
    Hispanic6(2%)7(1%)2(1%)
    Missing10(3%)5(1%)1(0%)
    Years of Education, mean (S.D.)14.88(S.D. = 3.32)14.45(S.D. = 2.81)13.87(S.D. = 3.04)P < .001
    Site
    UM209(72%)456(72%)227(69%)P = .554
    Beaumont80(28%)174(28%)101(31%)
    Trouble Communicating with Doctor
    A lot3(1%)12(2%)31(9%)P < .001
    A little98(34%)234(37%)159(48%)
    None188(65%)384(61%)138(42%)
    Confidence in Filling Medical Forms
    Not at all22(8%)55(9%)67(20%)P < .001
    A little bit17(6%)33(5%)27(8%)
    Somewhat33(11%)94(15%)69(21%)
    Quite a bit67(23%)174(28%)76(23%)
    Extremely149(52%)273(43%)88(27%)
    Missing1(0%)1(0%)1(0%)
    General Health
    Poor61(21%)130(21%)66(20%)P = .118
    Fair79(27%)199(32%)94(29%)
    Good98(34%)202(32%)106(32%)
    Very good32(11%)74(12%)42(13%)
    Excellent15(5%)16(3%)7(2%)
    Missing4(1%)9(1%)13(4%)
    In last month, days with poor Mental Health, mean (S.D.)10.07(S.D. = 11.16)9.34(S.D. = 11.16)9.12(S.D. = 11.07)P = .554
    Within past year food you bought didn't last and didn't have enough money to buy more
    Never true256(89%)577(92%)307(94%)P = .031
    Sometimes true27(9%)41(7%)16(5%)
    Often true5(2%)11(2%)1(0%)
    Missing1(0%)1(0%)4(1%)
    Grouped Charlson Index
    0 Conditions58(20%)78(12%)23(7%)P < .001
    1 Comorbidity43(15%)79(13%)39(12%)
    2+ Comorbidities188(65%)473(75%)266(81%)
    Deceased within 90 Days27(9%)58(9%)30(9%)P = .996
    30 Day Readmission45(16%)100(16%)53(16%)P = .980
    90 Day Readmission80(28%)157(25%)79(24%)P = .557
    • Abbreviation: SD, standard deviation.

    • View popup
    Table 2.

    Cox Proportional Hazard Model for Readmission at 30 and 90 Days, by any Hearing Loss (HL)

    30 Day Readmission90 Day Readmission
    HR95% CIp-ValueHR95% CIp-Value
    Any Evidence of HL (Ref = No)0.88[0.60, 1.29]0.510.80[0.60, 1.07]0.14
    Age0.99[0.97, 1.01]0.240.99[0.98, 1.00]0.19
    Years Education0.95[0.90, 1.01]0.090.96[0.92, 1.00]0.07
    Gender (Ref = Female)
    Male0.95[0.70, 1.28]0.730.87[0.69, 1.10]0.24
    Charlson Index (Ref = 0)1.001.00
    1 Comorbidity2.25[0.97, 5.23]0.061.33[0.70, 2.53]0.38
    2+ Comorbidity4.00[1.93, 8.27]0.003.27[1.98, 5.43]0.00
    Race (Ref = White)
    Black0.68[0.37, 1.27]0.230.78[0.50, 1.22]0.28
    Other0.92[0.34, 2.48]0.870.93[0.44, 1.97]0.85
    Health Literacy1.00[0.89, 1.13]0.950.95[0.86, 1.04]0.24
    Trouble communicating with Dr. (Ref = Lot of trouble)
    A little trouble0.71[0.35, 1.45]0.351.19[0.62, 2.29]0.60
    No trouble0.64[0.31, 1.31]0.221.06[0.55, 2.05]0.87
    Health system (Ref = UM)
    Beaumont1.12[0.80, 1.58]0.511.04[0.79, 1.37]0.78
    • Abbreviations: UM, University of Michigan; HR, hazard ratio; CI, confidence interval.

    • View popup
    Table 3.

    Cox Proportional Hazards on Readmission at 30 and 90 Days, among Those with HL Who Use an Hearing Loss (HL) Device

    30 Day Readmission90 Day Readmission
    HR95% CIp-ValueHR95% CIp-Value
    Device Use (Ref = None)
    HL Device0.77[0.49, 1.23]0.280.80[0.56, 1.15]0.23
    Age0.98[0.97, 1.00]0.140.98[0.97, 1.00]0.05
    Years Education0.94[0.87, 1.00]0.060.96[0.91, 1.01]0.13
    Gender (Ref = Female)
    Male0.96[0.68, 1.36]0.840.86[0.65, 1.13]0.27
    Charlson Index (Ref = 0)
    1 Comorbidity1.80[0.67, 4.82]0.241.18[0.53, 2.61]0.69
    2+ Comorbidity3.48[1.50, 8.06]0.003.19[1.71, 5.96]0.00
    Race (Ref = White)
    Black0.68[0.31, 1.48]0.330.72[0.40, 1.30]0.28
    Other0.99[0.31, 3.13]0.991.16[0.51, 2.61]0.73
    Health Literacy1.02[0.89, 1.17]0.810.93[0.84, 1.04]0.20
    Trouble communicating with Dr. (Ref = Lot of trouble)
    A little trouble0.74[0.35, 1.57]0.431.20[0.60, 2.40]0.61
    No trouble0.63[0.29, 1.35]0.241.03[0.51, 2.09]0.93
    Health system (Ref = UM)
    Beaumont1.31[0.89, 1.92]0.171.20[0.88, 1.63]0.25
    • Abbreviations: UM, University of Michigan; HR, hazard ratio; CI, confidence interval.

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The Journal of the American Board of Family     Medicine: 38 (1)
The Journal of the American Board of Family Medicine
Vol. 38, Issue 1
January-February 2025
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The Association of Hearing Loss with Hospitalization
Philip Zazove, Melissa A. Plegue, Elie Mulhem, Kate Panzer, Samantha Ratakonda, Ananda Sen, Jenna Greenberg, Anna McEvoy, Paul R. Kileny, Michael M. McKee
The Journal of the American Board of Family Medicine May 2023, jabfm.2022.220407R1; DOI: 10.3122/jabfm.2022.220407R1

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The Association of Hearing Loss with Hospitalization
Philip Zazove, Melissa A. Plegue, Elie Mulhem, Kate Panzer, Samantha Ratakonda, Ananda Sen, Jenna Greenberg, Anna McEvoy, Paul R. Kileny, Michael M. McKee
The Journal of the American Board of Family Medicine May 2023, jabfm.2022.220407R1; DOI: 10.3122/jabfm.2022.220407R1
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