Catchment Profile of Large Cochlear Implant Centers in the United States

Abstract

Objective

To characterize the catchment area and patient profile of large cochlear implant (CI) centers in the United States.

Study Design

Multi-institutional retrospective case series.

Setting

Tertiary referral CI centers.

Methods

Patients who underwent CI surgery at 7 participating CI centers between 2015 and 2020 were identified. Patients’ residential zip codes were used to approximate travel distances and urban vs rural residential areas.

Results

Over the 6-year study period (2015-2020), 6313 unique CI surgical procedures occurred (4529 adult, 1784 pediatric). Between 2015 and 2019, CI procedures increased by 43%. Patients traveled a median 52 miles (interquartile range, 21-110) each way; patients treated at rural CI centers traveled greater distances vs those treated at urban centers (72 vs 46 miles, P < .001). Rural residents represented 61% of the patient population and traveled farther than urban residents (73 vs 24 miles, P < .001). Overall, 91% of patients lived within a 200-mile radius of the institution, while 71% lived within a 100-mile radius. In adults, multiple regression analysis redemonstrated an association between greater travel distances and (1) older age at the time of CI and (2) residential rural setting (both P < .001, r² = 0.2).

Conclusions

While large CI centers serve geographically dispersed populations, most patients reside within a 200-mile radius. Strategies to expand CI utilization may leverage remote programming, telemedicine, and strategic placement of new centers and satellite clinics to ameliorate travel burden.