Title: 'Bridging the Gap: Assessment of Hearing Healthcare Barriers in Appalachia'
Track: 4 - Early Intervention
Keyword(s): Healthcare disparity, Appalachia, Cochlear implantation, Early hearing detection
Learning Objectives:
  1. Define the delay in diagnosis and treatment for children with hearing loss in Appalachia
  2. Describe the factors that contribute to delayed diagnosis and treatment in children from Appalachia
  3. Identify methods that may promote timely diagnosis and intervention for pediatric hearing loss


Compliance with diagnostic and intervention services for children who do not pass a hearing screening or who are diagnosed with hearing loss has become a major national healthcare concern. A disparity in diagnostic and intervention services in rural regions places many patients at a high risk of becoming lost to follow-up. Socioeconomic and cultural barriers may also compound these concerns. Appalachia is one such region and is recognized nationally as suffering from extreme health disparities and is underserved in many healthcare services. The purpose of this study was to examine the timing of early intervention diagnostic and therapeutic services in the Appalachian region of Kentucky. By examining the age of diagnosis and age of appropriate interventions, including cochlear implantation, we have begun to characterize the gap that is present in hearing healthcare in the Appalachian region of Kentucky. We found that children that fail newborn hearing screening in Appalachian regions are delayed in diagnosis, utilization of rehabilitative services and treatments, and cochlear implantation compared with those patients that reside in non-Appalachian regions. Associated medical, social, and educational factors were also examined. Furthermore, we present some methods of addressing this hearing healthcare disparity in this underserved and poorly studied population. Through this research, we seek to improve auditory rehabilitation of children in Appalachia and provide these services in a timely manner.
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Matthew L. Bush, M.D. - POC,Primary Presenter,Author
University of Kentucky Dept. of Otolaryngology
     Credentials: Assistant Professor, Department of Otolaryngology - Head and Neck Surgery
     Other Affiliations: Chief, Veterans Affairs Medical Center, Lexington, KY
      Matthew L. Bush, M.D. is an Assistant Professor in the Department of Otolaryngology – Head and Neck Surgery. He earned his M.D. degree at Marshall University in Huntington, WV in 2003. He completed Otolaryngology residency at the University of Kentucky in 2008 followed by a post-doctoral research fellowship and Neurotology & Cranial Base Surgery fellowship at The Ohio State University (2008-2011). Board certified in Otolaryngology and Neurotology, Dr. Bush’s clinical practice focuses on disorders of hearing and balance, including pediatric cochlear implantation. This clinical practice blends well with Dr. Bush’s research interests, which are directed at assessing and addressing rural pediatric and adult hearing health disparities. A K23 Career Development Award from the NIH National Institute of Deafness and Communication Disorders and a Triological Society Career Development Award supports this research. Recent research has been published in The Journal of Pediatrics, Ear & Hearing, The Laryngoscope, and Otology & Neurotology.

Financial - Receives Grants for Other activities from NIH.  

Nonfinancial - No relevant nonfinancial relationship exist.