Referral patterns to the Southern Cochlear Implant Programme for adult cochlear implant candidates: a retrospective review.

Abstract

Aim: The aim was to determine whether changes made to the Southern Cochlear Implant Programme (SCIP) following a previous audit in 20141 have affected referral patterns, and to identify ongoing areas of potential need that may inform future service provision and organisational policy. The primary objective was to assess whether changes in referral patterns (specifically distance to referral centre, ethnicity) occurred following interventions in SCIP service provision. The secondary objective was to evaluate the distribution of socio-economic deprivation for referrals to SCIP.

Methods: A retrospective review of all adult patients referred for consideration of cochlear implantation to the SCIP was conducted between 1 December 2014 and 1 December 2022. Distances to nearest SCIP referral centre were calculated based on patients' regions of domicile. This was modelled with linear regression to assess the relationship between incidence of referrals and distance to nearest SCIP centre. Along with demographic data, this was compared to the 2014 audit and baseline New Zealand population demographics from the 2018 New Zealand Census.

Results: In total, 793 individual patient referrals were identified and included. An improvement in referrals relative to distance to SCIP centre was demonstrated, along with a more even distribution of referrals across socio-economic groups. Assessment of ethnicity data was limited by the amount of unrecorded data.

Conclusion: Publicly funded cochlear implantation is currently a limited resource in New Zealand. Findings from this audit help assess both current and past service provisions, providing insights to guide future service developments. Interventions targeted at improving access to SCIP for those more geographically isolated from the service appear to be effective. These interventions, along with ongoing collection, audit and reporting of demographic data including ethnicity, should continue and help inform future service planning.