Hearing Healthcare context and ICF

Prevalence of hearing loss

1.5 billion people globally

• increases with degree of hearing loss

• increases with age

HA uptake in high income countries

Between 14-30%

Sonova share of HA market

31%

retail outlets they own in NZ are Triton Hearing and Blamey Saunders

Demant share of HA market

30%

retail outlets in NZ are Audika and Hearing Life

WS Audiology share of HA market

19%

retail outlet in NZ is Bloom

GN Nord Store share of HA market

15%

doesn’t have retail outlet

Non-manufacturer Retail Outlets

• Amplifon - Bay Audiology and Dilworth Hearing (largest retail outlet for HAs in NZ)

• Specsavers

Independent audiology clinics in canterbury

• Bishopdale Hearing

• Hearing Excellence

• Bellbird Hearing

• Sincock & Till Audiology

• Hear Again

• New Zealand Hearing

• Vera Setz Hearing

• Resonate

Who provides HA funding and to whom?

• Ministry of Health provides hearing aid subsidy to permanent residents and citizens

• subsidy provides $511.11 per hearing aid every 6 years

HA funding for children and some eligible adults

Ministry of Health covers entire cost of HAs and HA fitting

HA funding for HL due to injury

ACC funds HAs

HA funding for veterans

Veteran’s Support Act provides funding for HAs for eligible veterans with service-connected HL

ICF

biopsychosocial model that combines biological, psychological, and social elements into a single model

• disability and functions seen as outcomes of the interactions between a person’s health condition and contextual factors

Health condition

label that you put on the person’s health e.g. presbycusis

• can be a disease (e.g., diabetes) or a disorder (e.g., depression)

• impacts functioning, but also impacted by functioning

Bodily functions and structures

aspects of the person’s body that are affected by the health condition

Impairment

• negative expression of body fxns and structures

• problems w/ body structures and/or fxns

• e.g. mild sloping to moderate SNHL (degree, type and configuration of HL)

Activity

Something the person would like to do

e.g. hear GP and understand their instructions

Activity limitations

• something the person would like to do but can’t because of their impairment

• negative expression of activity

  e.g.

• can’t hear phone ring

• can’t hear soft speech

• can’t understand what people are saying in noise

• can’t understand dialogue on TV

Participation

being involved in life events - it’s social

e.g. socialising with friends at the cafe

Participation restrictions

not being able to engage socially in life events

• negative expression of participation

  e.g.

• miss out on chatting with friends on phone

• don’t participate in small group activities in classroom

• don’t go to the pub with friends

• don’t watch TV as a family

Environmental factors

relate to anything in the environment (external to person with health condition)

can be physical, social, or attitudinal

Environmental facilitator

things in environment which can improve or enhance functioning

• positive expression of environmental factor

e.g. supportive family, hearing aids etc

Environmental barriers

things in the environment that make functioning more difficult

• negative expression of environmental factors

  e.g. being in noisy group setting, bullying from peers about wearing HAs

Personal factors

anything about that person that either improves or hinders their functioning

e.g. age, gender, financial resources, psychological resources, personality, coping style, education, profession, past and current experience, and behaviour patterns

Third Party Disability

effect of others without the health condition

e.g. don’t go to pub because of partner’s participation restriction, don’t enjoy watching TV as a family