RESUMO
Introduction: In Chile, hearing loss (HL) is present in around 31% of the population above 18 years of age, representing the third cause of disability in this group. Considering the tremendous impact that HL has in the communication, wellbeing, and economy of each adult with HL, from 2018 this condition was included in the national high-cost health policy “Ley Ricarte Soto”. This regulation covers the diagnosis and intervention with Cochlear Implants (CI) to all adults with post lingual deafness. This is an evidence-based policy, which considers a strict process of pre-evaluation for each candidate, including international guidelines about CI in adults within local regulations in HL intervention. The above is especially important in the Chilean and Latin American context, where there might be additional factors affecting the outcomes expected with the CI. Aims: to characterise factors and outcomes in all adults implanted with CI under the Chilean high-cost policy from 2018 to 2020 and to investigate which factors affect their outcomes. Methodology: Information of 123 adults implanted from 2018-2020 was given by health authorities. 76 adults above 18 years of age accepted to participate in the study. The characterisation was completed using two sources of information: Clinical record information, and an online survey about factors and outcomes in OPINION platform. The characterisation considered 4 groups of factors and 3 outcomes The study is part of a PhD research and is supported by a small grant from a national public tender. Approval from two different Ethics Committees was obtained: in Chile(167-2020) and in the UK (LCD-2020-13).Results: Sociodemographic, audiological-medical, rehabilitation and CI use information were characterised as factors. Diversity in socioeconomic level and education was found. Considering the audiological aetiology, 35% of adults present unknown causes of HL. In rehabilitation, 56% of participants received weekly sessions of rehabilitation, and 71% reported it as “easy” for going to the health centre. Regarding outcomes, around 60% of users keep or improve their labour conditions, more than 60% of participants describe the service as “good” or “very good”, and the mean of satisfaction using CIRUA evaluation showed high results in the participants. Rehabilitation time and CI use are reported as important factors affecting outcomes in Chilean adults with CI. Conclusion:This first characterisation of adults with CI under the terms of the high-cost health policy shows promising results regarding the outcome expected in this group. A high level of satisfaction and use of the device show the possible effect of a detailed process of candidate selection. This is important considering the lack of resources in public health, and the high cost of the CI intervention and rehabilitation in Chile. Additionally, the good results in labour conditions outcome prove this intervention can impact not only in the communication but also in social determinant of health and economy of each adult.