17th ANNUAL EARLY HEARING DETECTION & INTERVENTION MEETING
March 18-20, 2018 • Denver, CO
| Differential Access to Diagnostic Hearing Screening in North Carolina: An Evaluation of Perinatal Care Regions
Differential Access to Diagnostic Hearing Screening in North Carolina: An Evaluation of Perinatal Care Regions
Introduction: Children born with a hearing loss are at an increased risk for delays in speech and language development as well as social development. In North Carolina, 99% of newborns are screened for hearing loss by three months of age. However, between 2011-2014 only 70% of children who screened positive had a diagnostic audiologic evaluation reported to the EHDI program. North Carolina is comprised of six perinatal care regions with the northeastern region having multiple hospital systems, the highest rate of primary care physicians per 10,000 population, and the greatest per capita income in 2012. This work evaluated differential loss to diagnostic follow (LTF) up by perinatal care region in North Carolina between 2011-2014. Methods: Using data from the EHDI program in NC between 2011-2014, we modeled the odds of diagnostic LTF up controlling for maternal education and maternal race/ethnicity by perinatal region in SAS version 9.4. Results: The odds of diagnostic LTF was approximately three times that for the eastern (OR: 3.79, 95% CI:2.08,6.9) and southeastern (OR: 3.08, 95% CI:1.68,5.63) regions compared to that of the northeastern region. The differential odds in LTF remained greatest for these two regions over time. The odds of LTF among children in the northwestern region was 0.36 and 0.50 times that of the Northeastern region in 2011 and 2012 respectively. However, by 2014 the odds of LTF for this region (OR:1.02, 95% CI: 0.57,1.82) was no different than the northeastern part of the state. Conclusion: Loss to follow up continues to remain a challenge in NC. The odds of children not receiving a diagnostic audiologic evaluation is greatest for the Eastern and Southeastern regions of the state when compared to the Northeastern region. Additional work will evaluate distribution of providers and factors associated with LTF in these high-risk regions.
- Describe diagnostic loss to follow up by regions of the state in NC
- Evaluate the trend in loss to follow up by region of the state over time
- Describe distribution of providers in regions with the highest loss to follow up over time
Presentation:
This presentation has not yet been uploaded or the speaker has opted not to make the presentation available online.
Handouts:
Handout is not Available
Transcripts:
CART transcripts are NOT YET available, but will be posted shortly after the conference
Presenters/Authors
Marcia Fort
(), NC DHHS, marcia.fort@dhhs.nc.gov;
Dr. Fort is the Genetics and Newborn Screening Unit Manager in the Whole Child Health Section of the North Carolina Division of Child and Family Well-Being and serves as the NC EHDI Coordinator. Marcia has worked with the NC EHDI program since 2002. Dr. Fort has 32 years of experience as a pediatric audiologist in hospital, private practice, ENT office and public school settings.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Stephanie Watkins
(), NC Division of Public Health, Women's and Children's Health Section, stephanie.watkins@dhhs.nc.gov;
Dr. Watkins is both a pediatric physical therapist and a neurodevelopmental epidemiologist with an interest in delivery of health services, social and environmental factors, and community interventions which influence health outcomes for women and children. She has over ten years of experience in maternal and child health working as both a pediatric physical therapist in NC schools as well a researcher on large population based studies. Dr. Watkins currently serves as both the Maternal and Child Health epidemiologist for the state of NC as well as a research scientist with the Center for Health Promotion and Disease prevention at the University of North Carolina at Chapel Hill. Her work uses methods in causal inference to estimate the effects of interventions in large population level databases.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
John Whisler
(), NC DPH, Early Hearing Detection and Intervention Program, john.whisler@dhhs.nc.gov;
Mr Whisler is the business analyst for the EDHI program
ASHA DISCLOSURE:
Financial -
Nonfinancial -