ปัจจัยที่มีความสัมพันธ์กับความต้องการเอกสารรับรองความพิการทางการได้ยิน ในผู้ป่วยที่มีภาวะการได้ยินบกพร่อง ณ โรงพยาบาลบึงกาฬ

Kanokkan Mahawerawat; Chonthicha  Chit-uea-ophat

doi:10.64960/srimedj.v41i3.270757

Authors

Kanokkan Mahawerawat Department of Otorhinolaryngology, Buengkan Hospital, Buengkan Province, Thailand 38000
Chonthicha Chit-uea-ophat Department of Otorhinolaryngology, Chaiyaphum Hospital, Chaiyaphum, Thailand 38000

DOI:

https://doi.org/10.64960/srimedj.v41i3.270757

Keywords:

hearing disability certification, associated factors, hearing aids, hearing disability

Abstract

Background and objectives: Hearing impairment is common among older adults in Thailand as the country transitions into an aging society. Management primarily involves hearing aid rehabilitation. Under the Universal Coverage Scheme (UCS), patients can obtain hearing disability certification and hearing aids at public hospitals. However, some patients request certification without pursuing hearing aids. This study aimed to identify factors associated with requests for hearing disability certification and the desire for hearing aids.

Methods: A hospital-based prospective observational analytic study was conducted among patients presenting with hearing complaints at the Otorhinolaryngology outpatient clinic, Bung Kan Hospital, from December 1, 2024, to December 31, 2025. Data were collected using structured questionnaires, medical history, physical examination, and audiometric evaluation. Pure-tone audiometry was performed using standard procedures, and the pure tone average (PTA) was calculated from thresholds at 0.5, 1, 2, and 4 kHz in the better ear. Participants were classified into two groups according to their request for a hearing disability certificate. Factors associated with the demand for certification were analyzed using multivariable logistic regression.

Results: Of 385 patients, 294 (76.4%) requested hearing disability certification, while 91 (23.6%) did not. Factors significantly associated with certification requests included age ≥60 years (adjusted odds ratio (AOR) 3.91, 95% CI 2.01–7.63), monthly income <10,000 THB (AOR 2.15, 95% CI 1.04–4.41), duration of hearing symptoms ≥12 months (AOR 3.12, 95% CI 1.53–6.37), and a better-ear pure tone average ≥61 dB (AOR 11.05, 95% CI 2.42–50.43). Among those requesting certification, 70.2% expressed a demand for hearing aids (p < 0.001), 73.8% met the criteria for hearing disability (p < 0.001). Of the 226 patients with confirmed disability, 171 (75.7%) expressed a desire for hearing aids; however, only 92 (53.8%) ultimately received them (p < 0.001).

Conclusions: Age, socioeconomic and clinical factors were significantly associated with requests for hearing disability certification. Although the majority of patients with confirmed disability desired hearing aids, only about half ultimately received them, highlighting the need to improve access to hearing rehabilitation services.

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