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S A ?s"*    ? : @::  m : h, @ 3 '"0@@@``   ? : `6  ; ^: h*:  ' B c &A ??s"*    ? : 2 @ m ;': h_ C 3 )"0@@@``   ? : `6 @( ; 8: ha:  ) D S A ?s"*    ? : @:: @( m O: hb E 3 *"0@@@``   ? : `6 9 : b: hd:  * G S A ?s"*    ? : hb5 O m `v: hh H 3 ,"0@@@``   ? : ` v m : hj:  , I 3 -"0@@@``   ? : # m m : hk:  -      !"#$%&'()*+,-CHNKINK +TEXTTEXT6STSHSTSH8PSTSHSTSH*9STSHSTSH@$FDPPFDPPBFDPPFDPPDFDPCFDPCFFDPCFDPCHFDPCFDPCJFDPCFDPCLFDPCFDPCNFDPCFDPCPFDPCFDPCRFDPCFDPCTFDPCFDPCVFDPC FDPCXFDPC FDPCZFDPC FDPC\FDPC FDPC^The New Zealand Pilot Study of EARtrak"! Anne Greville PhD Susan Clutterbuck Greville Consulting Gippsland Audiology Services Auckland, New Zealand Victoria, Australia EARtrak"! is a client outcome measurement process to monitor hearing aid satisfaction. It was developed in Australia, and involves internationally sourced survey materials - primarily the IOI-HA (the International Outcome inventory for Hearing Aids described by Cox et al 2000) together with questions developed by Sergei Kochkin for MarkeTrak in the USA). Data collection and analysis is carried out by an independent consultant, in this case, Greville Consulting. The pilot study examined its use in five New Zealand audiology practices. 212 clients were sent surveys. Completed surveys were received from 160 people, a response rate of 75%. The results are compared with equivalent data from a sample of ten Australian practices participating in the programme during the same time period (July  October 2004). 648 Australian hearing aid users were contacted, with 351 responding  a response rate of 54%. Note that this was not a special study for the Australian practices, some of whom did not send out reminder letters to their clients, as was done with the NZ participants. Hearing Loss 53% of respondents had no more than mild hearing loss in their better ear. This compares with 27% in the Australian data. This would be expected to impact negatively on the NZ satisfaction data. Experience 38% of respondents were experienced hearing aid users, cf 52% of the Australian group. The NZ practices involved tended to be newer, and perhaps having to seek out new clients.The binaural fitting rate was identical to the Australian group. Hearing aid style There has been a swing in Australia back to BTEs (39%), not evident in the NZ data (23%). More CICs are fitted in the NZ group (16% cf 6%), probably related to the milder hearing losses being fitted with hearing aids. Hearing aid technology The higher rate of single program aids in the Australian group (34% cf 18% for the New Zealand sample) is related to the high proportion of OHS-funded clients in the group. Similarly, only 36% of the Australian sample had dual microphones, compared with 52% of the New Zealand group. NZ Pilot AU Group Private 33% 37% Veterans Affairs 9% 1% Compensation 48% 7% Enable/Accessable (Health) 9% OHS (Health & Aging) 56% Referrals For the NZ group, print media are the largest source of referrals, although very low in the Australian group. Of concern for the NZ group is the low friend/relative referral rate  probably linked to the  newness of the practices involved in the pilot. Daily Use of Hearing Aids 40% used their hearing aid/s for 8+ hours a day (cf 45% in the Australian group). This lower rate is probably related to the milder hearing losses in the NZ group. 3% of respondents did not use their hearing aids. Hours / day NZ Pilot AU Group 0 3% 4% <1 5% 6% 1-4 28% 21% 5-8 25% 25% 8+ 40% 45% IOI-HA The individual item mean scores are arranged with the four positive satisfaction sub-scale items on the left, and the three residual difficulty items on the right. IOI-HA Summary Scores General Satisfaction Over the whole group, 84% were satisfied with their hearing aid/s. 88% recommended hearing aids.94% recommended the service they had received. There was considerable practice variation (shown by ranges). These results compare favourably with comparable Australian data, as well as published US MarkeTrak data (Kochkin, 2003) for people with new hearing aids Listening situations The following graphs show percentages satisfied. The error bars indicate the range of ratings for the practices in the pilot group. Anne Greville PhD, Greville Consulting, Auckland, New Zealand Susan Clutterbuck, Gippsland Audiology Services, Victoria, Australia Age & Gender The mean age of the Australian and New Zealand survey participants was identical  70 years. A higher proportion of the New Zealand group was male (67% cf 58% of the Australian group), probably reflecting poor funding of hearing aids for elderly women in New Zealand. Funding The most significant feature here is the difference between the Health sector funding which in NZ is only 9%, compared with 56% of the Australian group. In NZ, ACC tends to take up much of the funding responsibility, primarily for men. NZ Pilot AU Group Newspaper/magazine 21% 4% Doctor 18% 35% Friend/relative 13% 21% ACC/ Work cover 13% 0% Yellow pages 9% 11% Premises/signs 7% 1% Other 17% 28% Satisfaction & Funder Satisfaction has been shown to be related to cost. Privately funded clients tend to be slightly less satisfied than those whose aids are funded by a third party. The higher daily use by the Enable/Accessable clients would be related to their being younger and with more severe hearing losses than other funding groups. Note that the Veterans Affairs & ACC clients have high satisfaction ratings, despite relatively low rates of all day use (probably related to their older average age). Listening situations with the largest ranges (& hence potentially room for improvement for those practices scoring at the lower end of the range): Large groups (21%) Car (20%) Concert/movies (20%) Outdoors (19%) Telephone (18%) Workplace (18%) Church/lectures (16%) TV (16%) Hearing aid features Hearing aid features with the largest ranges (& hence potentially room for improvement for those practices scoring at the lower end of the range) were: Localisation (35%) Whistling (29%) Visibility (21%) Loud sounds (19%) Volume adjustment (16%) Frequency of cleaning (16%) Voice sound (15%) Reliability (15%) Service features Satisfaction ratings were very high for this part of the survey. Service features with the largest ranges (& hence potentially room for improvement for those practices scoring at the lower end of the range) were: Post-purchase service (10%) Patience (9%)Professionalism (9%) Conclusions EARtrak is appropriate as an outcome measure for NZ hearing aid users. No difficulties were encountered in administration of the survey. Very high response rates were found, indicating a high level of acceptance of the survey. It is interesting that these high rates occurred despite no gifts being offered to participants, as is often the case in Australia. Generally high levels of satisfaction when compared to equivalent findings from other parts of the world were encountered, providing reassurance that New Zealand standards of hearing aid delivery are among the best in the world. References Cox, R, Hyde, M, Gatehouse, S, Noble, W, et al. Optimal outcome measures, research priorities, and international cooperation. Ear & Hearing, 21, 106S-115S, 2000 Kochkin, S. MarkeTrak VI: On the issue of value: hearing aid benefit, price, satisfaction, and repurchase rates. Hearing Review: 10, No 2, 2003. Kramer, SE, Goverts, ST, Dreschler, WA et al. International Outcome Inventory for Hearing Aids: results from the Netherlands. 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