Audiologist Availability and Supply in the United States: A Multi-Scale Spatial and Political Economic Analysis

Authors: Arrianna Marie Planey*, University of Illinois
Topics: Medical and Health Geography, Spatial Analysis & Modeling, Geographic Information Science and Systems
Keywords: audiologists; audiology; health care providers; health care access; health care provider supply; health policy; hearing loss
Session Type: Paper
Day: 4/4/2019
Start / End Time: 3:05 PM / 4:45 PM
Room: Madison A, Marriott, Mezzanine Level
Presentation File: No File Uploaded

This study employs statistical modeling and mapping techniques to analyze the availability and accessibility of audiologists (practitioners who diagnose and treat hearing loss) in the United States at two scales: state and county. The goal is to assess the relationships between socio-demographic and structural factors (such as health policy and clinical programs which train audiologists) and audiologist availability. These associations are analyzed at the state level via negative binomial regression modeling and at the county level, via a mixed effects hurdle model. The state-level model found that audiologist supply is positively associated with number of clinical audiology (Au.D) programs and negatively associated with population density. In both the state and county models, the proportion of older adults reporting difficulty hearing is negatively associated with audiologist supply. A wider array of contextual factors emerges as significant in the county-scale analyses. I find that audiologists tend to locate in counties with younger populations, higher population densities, higher median income, lower percentages of uninsured population, and lower proportions of older adults reporting hearing difficulty, suggesting an inverse care-type relationship between audiologist supply and need for hearing health services. At both scales, state legislation requiring insurance plan coverage of hearing aids for adults is not a significant predictor of audiologist supply. While Medicaid coverage of audiology services is not a significant predictor of audiologist supply at the state level, it is positively associated with audiologist supply at the county level.

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