Referral patterns and gaps in financial coverage hinder appropriate treatment of Sudden Sensorineural Hearing Loss (SSNHL) with Hyperbaric Oxygen Therapy (HBOT).

Abstract

Objective: The objective of this web-based survey was to evaluate recent experiences of patients with Sudden Sensorineural Hearing Loss (SSNHL) in regard to treatment with Hyperbaric Oxygen Therapy (HBOT). The delays that exist in the referral process, the lack of awareness regarding the use of HBOT for this diagnosis, and discrepancies that exist in the reimbursement process were explored.
Design: Noninterventional survey of patients with a diagnosis of SSNHL was conducted from May 27, 2022, to July 13, 2022. The survey focused on the referral process, level of awareness in the general population, and level of
awareness in the medical community, regarding the use of HBOT for this diagnosis, as well as the reimbursement process. A total of 179 people received the survey.
Results: Sixty-two patients completed the survey. More than half of the patients, 53.2%, surveyed consider themselves as self-referred to HBOT and noted that they were not told about HBOT as a treatment option by a specialist. More than 67% of the patients surveyed report that medical insurance did not cover the cost of HBOT. Overall, the participants reported the successful use of HBOT, with 55.8% having complete or partial improvement. This rate of improvement is potentially higher considering more than half of the patients surveyed reported that they did not complete the recommended course of therapy with many citing costs as the barrier to care. Conclusion: The survey findings illustrate that patients may not be adequately educated by specialists regarding the addition of HBOT to their plan of care. When the information is conveyed, it is often conveyed after a delay in symptom onset. The lack of, or delay in, education contributes to poorer outcomes. Additionally, many patients who are recommended to receive HBOT are denied coverage by their insurance carriers which prevents access to appropriate care and presents a financial burden to those who seek care regardless. Discrepancies regarding referral, timing of referral and financial coverage levels present barriers to adequate and appropriate treatment, preventing many patients from receiving care that is evidence based.