(0251) Social Vulnerability Index and Cochlear Implantation: Are Disadvantaged Patients at Greater Risk of Care Discontinuation?

Introduction: Cochlear Implantation (CI) is the gold standard of treatment for sensorineural hearing loss. While CI is often successful in rehabilitating SNHL, post-surgical follow-up is necessary to maximize patient outcomes. This study examines the influence of social determinants of health, quantified by Social Vulnerability Index (SVI), on patient adherence to follow-up after CI surgery.

Methods: A chart review was performed for CI patients in the greater Memphis area since 2020. Data collected included home addresses, surgery date, and follow-ups at one, three, six, and twelve months post-surgically. The patient’s address was used to calculate the SVI. Follow-up was evaluated in time between appointments and follow-up attrition at each visit.

Results: Of 117 CI patients identified, 94 met inclusion criteria. Linear regression of patients attending all four follow-ups revealed no correlation between SVI and appointment intervals (R2 range: 0.0035 - 0.0199). Initial follow-up attendance was 100% across all quartiles. At six months, highest retention was observed in Q1 (50.00%), and lowest retention was seen in Q3 (38.10%). At twelve months, Q2 showed highest retention (66.67%), while the Q3 and Q4 had the lowest (42.86%-44.44%).

Conclusions: Post-operative visit patterns suggest patients in higher SVI quartiles face additional barriers to maintaining post-operative care. Significant attrition was seen for the more socially vulnerable groups, Q3 and Q4, at the 6-month and 12-month follow-up visits. Patients with lower social vulnerability in Q1 and Q2 had greater attendance at the 6-month and 12-month follow-ups. The top three counties that patients hailed from were Shelby (47.9%), DeSoto (16.2%), and Panola (4.3%), which had county-wide SVIs of 0.8803, 0.3164, and 0.8491 respectively. Despite over half the county averages being in the highest quartile, only 28.4% of CI recipients in the study were in the fourth quartile. This discrepancy underscores potential gaps in care for in socially vulnerable groups and highlights the need for strategies to improve follow-up adherence among socially disadvantaged CI patients.