R. Schönweiler

Entwicklung und Anwendung einer APHAB-Datenbank

ZusammenfassungIm Zusammenhang mit der Verordnung von Hörgeräten wurde ein Qualitätssicherungsbogen eingeführt, der Elemente der Ergebnisqualität im kassenärztlichen Bereich erfasst. Ein Fragebogenassessment ist nun für alle an der Versorgung gesetzlich Versicherter beteiligten Ärzte in Deutschland relevant. Der APHAB-Fragebogen (Abbreviated Profile of Hearing Aid Benefit) ist am weitesten verbreitet. Damit werden verschiedene Situationen abgefragt: die einfache Hörsituation, das Hören im Störgeräusch, Hören von Sprache in Echo- oder Hallsituationen und das Hören in lauten Situationen. Die Nutzenbewertung von Hörgeräten durch den Patienten mittels des APHAB-Fragebogens stellt eine dritte Säule in der audiologischen Diagnostik neben der klassischen Ton- und Sprachaudiometrie dar. Ziel der ABHAB-Datenbank ist es, individuelle Patientendaten vor dem Hintergrund einer größeren Datenmenge beurteilen zu können.AbstractA specific quality assurance questionnaire concerned with the provision of hearing aids was introduced that assesses elements of patient satisfaction within Germany’s statutory healthcare system. A questionnaire-based assessment is now relevant for all physicians involved in the care of statutorily insured patients in Germany. The APHAB (Abbreviated Profile of Hearing Aid Benefit) questionnaire is the most widely used. The APHAB assesses several different situations: the normal hearing situation, hearing in noise, comprehension of speech in situations of echo or reverberation and hearing in loud situations. The APHAB questionnaire-based patient evaluation of the benefit of hearing aids represents the third pillar of audiological diagnostics, alongside classical pure-tone and speech audiometry. The objective of the APHAB database is to allow evaluation of individual patient data on the basis of a larger volume of data.A specific quality assurance questionnaire concerned with the provision of hearing aids was introduced that assesses elements of patient satisfaction within Germanys statutory healthcare system. A questionnaire-based assessment is now relevant for all physicians involved in the care of statutorily insured patients in Germany. The APHAB (Abbreviated Profile of Hearing Aid Benefit) questionnaire is the most widely used. The APHAB assesses several different situations: the normal hearing situation, hearing in noise, comprehension of speech in situations of echo or reverberation and hearing in loud situations. The APHAB questionnaire-based patient evaluation of the benefit of hearing aids represents the third pillar of audiological diagnostics, alongside classical pure-tone and speech audiometry. The objective of the APHAB database is to allow evaluation of individual patient data on the basis of a larger volume of data.

Umsetzung der neuen Qualitätssicherungsvereinbarung zur Hörgeräteversorgung im Praxisalltag

Alongside evidence-based medicine, quality assurance has becoming increasingly important in daily medical practice during the last decade. The introduction of a specific quality assurance questionnaire in connection with hearing aid fitting represents the first large-scale assessment of certain elements of patient satisfaction within Germanys public healthcare system. Part 1 of this review describes the most important new regulations pertaining to hearing aid fitting in the context of statutory health insurance. Since the vast majority of diagnostic and therapeutic procedures constituting the treatment of hearing loss patients--particularly the subsequent rehabilitation of hearing aid wearers in cooperation with hearing aid acousticians--occur outside the clinic, this review concentrates on the rules relevant to this area. After studying this part of the overview, readers should be able to understand and apply the sections of the statutory health insurance reimbursement guidelines relating to ambulant hearing aid fitting; furthermore, they should be able to understand and apply the standard evaluation criteria (Einheitlicher Bewertungsmaßstab, EBM).

Development and use of an APHAB database

ZusammenfassungIm Zusammenhang mit der Verordnung von Hörgeräten wurde ein Qualitätssicherungsbogen eingeführt, der Elemente der Ergebnisqualität im kassenärztlichen Bereich erfasst. Ein Fragebogenassessment ist nun für alle an der Versorgung gesetzlich Versicherter beteiligten Ärzte in Deutschland relevant. Der APHAB-Fragebogen (Abbreviated Profile of Hearing Aid Benefit) ist am weitesten verbreitet. Damit werden verschiedene Situationen abgefragt: die einfache Hörsituation, das Hören im Störgeräusch, Hören von Sprache in Echo- oder Hallsituationen und das Hören in lauten Situationen. Die Nutzenbewertung von Hörgeräten durch den Patienten mittels des APHAB-Fragebogens stellt eine dritte Säule in der audiologischen Diagnostik neben der klassischen Ton- und Sprachaudiometrie dar. Ziel der ABHAB-Datenbank ist es, individuelle Patientendaten vor dem Hintergrund einer größeren Datenmenge beurteilen zu können.AbstractA specific quality assurance questionnaire concerned with the provision of hearing aids was introduced that assesses elements of patient satisfaction within Germany’s statutory healthcare system. A questionnaire-based assessment is now relevant for all physicians involved in the care of statutorily insured patients in Germany. The APHAB (Abbreviated Profile of Hearing Aid Benefit) questionnaire is the most widely used. The APHAB assesses several different situations: the normal hearing situation, hearing in noise, comprehension of speech in situations of echo or reverberation and hearing in loud situations. The APHAB questionnaire-based patient evaluation of the benefit of hearing aids represents the third pillar of audiological diagnostics, alongside classical pure-tone and speech audiometry. The objective of the APHAB database is to allow evaluation of individual patient data on the basis of a larger volume of data.A specific quality assurance questionnaire concerned with the provision of hearing aids was introduced that assesses elements of patient satisfaction within Germanys statutory healthcare system. A questionnaire-based assessment is now relevant for all physicians involved in the care of statutorily insured patients in Germany. The APHAB (Abbreviated Profile of Hearing Aid Benefit) questionnaire is the most widely used. The APHAB assesses several different situations: the normal hearing situation, hearing in noise, comprehension of speech in situations of echo or reverberation and hearing in loud situations. The APHAB questionnaire-based patient evaluation of the benefit of hearing aids represents the third pillar of audiological diagnostics, alongside classical pure-tone and speech audiometry. The objective of the APHAB database is to allow evaluation of individual patient data on the basis of a larger volume of data.

[Implementation of the new quality assurance agreement for the fitting of hearing aids in daily practice. Part 1: New regulations pertaining to hearing aid fitting].

Alongside evidence-based medicine, quality assurance has becoming increasingly important in daily medical practice during the last decade. The introduction of a specific quality assurance questionnaire in connection with hearing aid fitting represents the first large-scale assessment of certain elements of patient satisfaction within Germanys public healthcare system. Part 1 of this review describes the most important new regulations pertaining to hearing aid fitting in the context of statutory health insurance. Since the vast majority of diagnostic and therapeutic procedures constituting the treatment of hearing loss patients--particularly the subsequent rehabilitation of hearing aid wearers in cooperation with hearing aid acousticians--occur outside the clinic, this review concentrates on the rules relevant to this area. After studying this part of the overview, readers should be able to understand and apply the sections of the statutory health insurance reimbursement guidelines relating to ambulant hearing aid fitting; furthermore, they should be able to understand and apply the standard evaluation criteria (Einheitlicher Bewertungsmaßstab, EBM).

[Hearing aid fitting: Effect of doubling the standard rate on compliance, quality of results, and excess payments].

BACKGROUND This study investigates the effect that doubling the standard rate for hearing aid fitting which is covered by statutory insurance has had on the size of excess payments and compliance, as well as on benefits for patients and their satisfaction. METHODS In April 2014, 859 members of a statutory insurance scheme (hkk) who received hearing aids in the 6 months prior to the reform were questioned on the timing and financial details of their hearing aid fitting, as well as on treatment compliance and quality of the results using a standardized questionnaire. In October 2014, the same questionnaire was used to collect these data from a further 622 insurance holders who had received hearing aids in the 8 months following introduction of the new regulation. Most of the questions concerning hearing quality corresponded to those of the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire. RESULTS The project revealed a statistically significant decrease of 6 percent points in the proportion of hearing aid users who had to pay any excess whatsoever; from 80.6% to 74.1%. However, 40% of the insured persons continued to pay an excess of 1000 euros and more. The subjective hearing quality remained practically unimproved by the reform and was statistically, almost without exception, independent of whether hearing aid users wore expensive devices associated with a large excess, or devices available at the standard rate. Finally, the study confirmed a previously recognized usage pattern characterized by noncompliance. For example, approximately 40% of hearing aid users did not wear their device in the everyday environment. This observation was independent of the size of the excess and the timing of the most recent visit to the hearing aid acoustician. CONCLUSION Despite doubling of the standard rate, three quarters of patients pay an excess--sometimes a substantial one. The subjective hearing quality was not improved by doubling the standard rate; the majority of patients continue to complain of considerable problems with hearing in difficult situations (environments with background or reverberant noise). Satisfaction with hearing quality is neither dependent on the doubling of the standard rate, nor on whether or not an excess was paid. Compliance may possibly be improved by structured follow-up, which should involve the prescribing otorhinolaryngologists, as well as phoniatrists, pedaudiologists, and hearing aid acousticians.

HörgeräteversorgungHearing aid fitting

BACKGROUND This study investigates the effect that doubling the standard rate for hearing aid fitting which is covered by statutory insurance has had on the size of excess payments and compliance, as well as on benefits for patients and their satisfaction. METHODS In April 2014, 859 members of a statutory insurance scheme (hkk) who received hearing aids in the 6 months prior to the reform were questioned on the timing and financial details of their hearing aid fitting, as well as on treatment compliance and quality of the results using a standardized questionnaire. In October 2014, the same questionnaire was used to collect these data from a further 622 insurance holders who had received hearing aids in the 8 months following introduction of the new regulation. Most of the questions concerning hearing quality corresponded to those of the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire. RESULTS The project revealed a statistically significant decrease of 6 percent points in the proportion of hearing aid users who had to pay any excess whatsoever; from 80.6% to 74.1%. However, 40% of the insured persons continued to pay an excess of 1000 euros and more. The subjective hearing quality remained practically unimproved by the reform and was statistically, almost without exception, independent of whether hearing aid users wore expensive devices associated with a large excess, or devices available at the standard rate. Finally, the study confirmed a previously recognized usage pattern characterized by noncompliance. For example, approximately 40% of hearing aid users did not wear their device in the everyday environment. This observation was independent of the size of the excess and the timing of the most recent visit to the hearing aid acoustician. CONCLUSION Despite doubling of the standard rate, three quarters of patients pay an excess--sometimes a substantial one. The subjective hearing quality was not improved by doubling the standard rate; the majority of patients continue to complain of considerable problems with hearing in difficult situations (environments with background or reverberant noise). Satisfaction with hearing quality is neither dependent on the doubling of the standard rate, nor on whether or not an excess was paid. Compliance may possibly be improved by structured follow-up, which should involve the prescribing otorhinolaryngologists, as well as phoniatrists, pedaudiologists, and hearing aid acousticians.

Hörgeräteversorgung@@@Hearing aid fitting: Folgen der Festbetragsverdoppelung auf Compliance, Ergebnisqualität und Zuzahlungen@@@Effect of doubling the standard rate on compliance, quality of results, and excess payments

BACKGROUND This study investigates the effect that doubling the standard rate for hearing aid fitting which is covered by statutory insurance has had on the size of excess payments and compliance, as well as on benefits for patients and their satisfaction. METHODS In April 2014, 859 members of a statutory insurance scheme (hkk) who received hearing aids in the 6 months prior to the reform were questioned on the timing and financial details of their hearing aid fitting, as well as on treatment compliance and quality of the results using a standardized questionnaire. In October 2014, the same questionnaire was used to collect these data from a further 622 insurance holders who had received hearing aids in the 8 months following introduction of the new regulation. Most of the questions concerning hearing quality corresponded to those of the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire. RESULTS The project revealed a statistically significant decrease of 6 percent points in the proportion of hearing aid users who had to pay any excess whatsoever; from 80.6% to 74.1%. However, 40% of the insured persons continued to pay an excess of 1000 euros and more. The subjective hearing quality remained practically unimproved by the reform and was statistically, almost without exception, independent of whether hearing aid users wore expensive devices associated with a large excess, or devices available at the standard rate. Finally, the study confirmed a previously recognized usage pattern characterized by noncompliance. For example, approximately 40% of hearing aid users did not wear their device in the everyday environment. This observation was independent of the size of the excess and the timing of the most recent visit to the hearing aid acoustician. CONCLUSION Despite doubling of the standard rate, three quarters of patients pay an excess--sometimes a substantial one. The subjective hearing quality was not improved by doubling the standard rate; the majority of patients continue to complain of considerable problems with hearing in difficult situations (environments with background or reverberant noise). Satisfaction with hearing quality is neither dependent on the doubling of the standard rate, nor on whether or not an excess was paid. Compliance may possibly be improved by structured follow-up, which should involve the prescribing otorhinolaryngologists, as well as phoniatrists, pedaudiologists, and hearing aid acousticians.

Entwicklung und Anwendung einer APHAB-Datenbank@@@Development and use of an APHAB database

ZusammenfassungIm Zusammenhang mit der Verordnung von Hörgeräten wurde ein Qualitätssicherungsbogen eingeführt, der Elemente der Ergebnisqualität im kassenärztlichen Bereich erfasst. Ein Fragebogenassessment ist nun für alle an der Versorgung gesetzlich Versicherter beteiligten Ärzte in Deutschland relevant. Der APHAB-Fragebogen (Abbreviated Profile of Hearing Aid Benefit) ist am weitesten verbreitet. Damit werden verschiedene Situationen abgefragt: die einfache Hörsituation, das Hören im Störgeräusch, Hören von Sprache in Echo- oder Hallsituationen und das Hören in lauten Situationen. Die Nutzenbewertung von Hörgeräten durch den Patienten mittels des APHAB-Fragebogens stellt eine dritte Säule in der audiologischen Diagnostik neben der klassischen Ton- und Sprachaudiometrie dar. Ziel der ABHAB-Datenbank ist es, individuelle Patientendaten vor dem Hintergrund einer größeren Datenmenge beurteilen zu können.AbstractA specific quality assurance questionnaire concerned with the provision of hearing aids was introduced that assesses elements of patient satisfaction within Germany’s statutory healthcare system. A questionnaire-based assessment is now relevant for all physicians involved in the care of statutorily insured patients in Germany. The APHAB (Abbreviated Profile of Hearing Aid Benefit) questionnaire is the most widely used. The APHAB assesses several different situations: the normal hearing situation, hearing in noise, comprehension of speech in situations of echo or reverberation and hearing in loud situations. The APHAB questionnaire-based patient evaluation of the benefit of hearing aids represents the third pillar of audiological diagnostics, alongside classical pure-tone and speech audiometry. The objective of the APHAB database is to allow evaluation of individual patient data on the basis of a larger volume of data.A specific quality assurance questionnaire concerned with the provision of hearing aids was introduced that assesses elements of patient satisfaction within Germanys statutory healthcare system. A questionnaire-based assessment is now relevant for all physicians involved in the care of statutorily insured patients in Germany. The APHAB (Abbreviated Profile of Hearing Aid Benefit) questionnaire is the most widely used. The APHAB assesses several different situations: the normal hearing situation, hearing in noise, comprehension of speech in situations of echo or reverberation and hearing in loud situations. The APHAB questionnaire-based patient evaluation of the benefit of hearing aids represents the third pillar of audiological diagnostics, alongside classical pure-tone and speech audiometry. The objective of the APHAB database is to allow evaluation of individual patient data on the basis of a larger volume of data.

Umsetzung der neuen Qualitätssicherungsvereinbarung zur Hörgeräteversorgung im PraxisalltagImplementation of the new quality assurance agreement for the fitting of hearing aids in daily practice

Alongside evidence-based medicine, quality assurance has becoming increasingly important in daily medical practice during the last decade. The introduction of a specific quality assurance questionnaire in connection with hearing aid fitting represents the first large-scale assessment of certain elements of patient satisfaction within Germanys public healthcare system. Part 1 of this review describes the most important new regulations pertaining to hearing aid fitting in the context of statutory health insurance. Since the vast majority of diagnostic and therapeutic procedures constituting the treatment of hearing loss patients--particularly the subsequent rehabilitation of hearing aid wearers in cooperation with hearing aid acousticians--occur outside the clinic, this review concentrates on the rules relevant to this area. After studying this part of the overview, readers should be able to understand and apply the sections of the statutory health insurance reimbursement guidelines relating to ambulant hearing aid fitting; furthermore, they should be able to understand and apply the standard evaluation criteria (Einheitlicher Bewertungsmaßstab, EBM).

Umsetzung der neuen Qualitätssicherungsvereinbarung zur Hörgeräteversorgung im Praxisalltag@@@Implementation of the new quality assurance agreement for the fitting of hearing aids in daily practice: Teil 1 Neue Regeln der Hörgeräteverordnung@@@Part 1 New regulations pertaining to hearing aid fitting

Alongside evidence-based medicine, quality assurance has becoming increasingly important in daily medical practice during the last decade. The introduction of a specific quality assurance questionnaire in connection with hearing aid fitting represents the first large-scale assessment of certain elements of patient satisfaction within Germanys public healthcare system. Part 1 of this review describes the most important new regulations pertaining to hearing aid fitting in the context of statutory health insurance. Since the vast majority of diagnostic and therapeutic procedures constituting the treatment of hearing loss patients--particularly the subsequent rehabilitation of hearing aid wearers in cooperation with hearing aid acousticians--occur outside the clinic, this review concentrates on the rules relevant to this area. After studying this part of the overview, readers should be able to understand and apply the sections of the statutory health insurance reimbursement guidelines relating to ambulant hearing aid fitting; furthermore, they should be able to understand and apply the standard evaluation criteria (Einheitlicher Bewertungsmaßstab, EBM).