Education qualification levels and school careers of unilateral versus bilateral hearing aid users.

Contains fulltext : 51872.pdf (publisher's version ) (Closed access)OBJECTIVE: Analyse the difference in school careers and secondary school qualification levels between unilateral hearing aid users and bilateral hearing aid users. STUDY DESIGN: Retrospective questionnaire study. SETTING: Postal-based questionnaire. PARTICIPANTS: Names of adults known to have been fitted with unilateral or bilateral hearing aids during childhood were retrieved. This resulted in 292 names. Participants were selected using the following criteria: availability of the medical record, presence of bilateral hearing loss, completed secondary school education, normal IQ and a minimum aided word-recognition score of 70% at 10 years of age. The questionnaire was sent to 50 potential participants of whom 40 responded, resulting in two groups comprising 19 unilateral and 21 bilateral hearing aid users. METHODS: A questionnaire was developed to obtain data on secondary school levels and aspects of the school careers, such as type of schools attended (mainstream versus special), repeating a school year and additional assistance (speech and language therapy, personal frequency modulation systems). MAIN OUTCOME MEASURES: Comparison of the benefit of bilateral hearing aid fitting versus unilateral hearing aid fitting on secondary school qualification level, type of school the children attended, class failure and additional assistance used. RESULTS: The group of bilaterally fitted hearing aid users eventually completed secondary school at a superior level than the unilaterally fitted users. 33% of binaural hearing aid users achieved qualifications giving access to a bachelors degree compared with 21% of unilateral users. There were no differences between those fitted with unilateral and bilateral hearing aids in the type of schools attended, repeating a school year and additional assistance. CONCLUSIONS: The bilateral hearing aid users obtained superior secondary school qualifications than the unilateral users but their school careers were comparable

Medical Practice under Managed Care: Cost-control Mechanisms and Impact on Quality of Service

The paper investigates the US experience of Managed Care. It describes the cost controlling measures and the new modes of payment that were implemented along with managed Care. Using theory and field surveys, it reviews how these measures have affected physician practices. The paper also investigates their impact on the quality of health services. Copyright Springer Science + Business Media, Inc. 2005HMO, Managed Care, patient, US, physician payment,