Time Matters: Possible Predictors of the Number of Appointments During the First Year After Hearing Aid Fitting.

A single university-affiliated clinic in southern Arizona, so the appointment numbers may not transfer to other settings or other pricing models. About 30% of the clinic's patients speak Spanish and the clinic has bilingual staff; needing an interpreter may have affected who came back. All care involved graduate student clinicians, who generally take longer to deliver the same service than experienced staff, and the researchers could not tell whether individual clinicians scheduled follow-ups differently. The out-of-pocket cost bands were chosen by the researchers rather than set in advance, and technology level, insurance coverage and out-of-pocket cost were so tangled that the paper cannot separate their contributions. No measure of benefit or satisfaction was collected, so the number of appointments says nothing about whether patients did better, and the chart review covered only one year. Patients funded through vocational rehabilitation or a local hearing aid bank were excluded because their appointment rules or prices differed, so the results do not describe them.

Megan J. Kobel received research support from the National Institute on Deafness and Other Communication Disorders (grant K01DC021147). No other funding or competing interests are stated in the text supplied.

Do not read the extra appointments for people who paid more as evidence that costlier devices or more visits produce better care. The study counted appointments only, it measured no benefit or satisfaction, and technology level and out-of-pocket cost were so closely tied together that the paper cannot say which of them explains the difference.