Bone-conduction hearing implants: a potential postcode lottery

Background Bone conduction hearing implants (BCHIs) are a valuable alternative option for patients with hearing loss when conventional hearing aids are not effective or a viable option. In the UK, specialist sites offer BCHI services. We aimed to understand whether patients face geographical barriers to accessing this healthcare service. Methods A retrospective cohort study was performed at five hospitals in the North West of England over a one-year period (January–December 2023). Results In total, 167 primary BCHIs were implanted (median age, 57.7 years; female, n=52 (31.1%)). Patients travelled a median distance of 17.3km from their home to the BCHI site. Of the patients receiving a BCHI, 108 (64.7%) lived in the locality of a BCHI site. The remaining 59 (35.3%) were referred from a non-BCHI centre. The majority of BCHIs were percutaneous (n=154/167, 92.2%) and were performed under local anaesthetic (n=127/167, 76.0%). No correlation between patient age and distance travelled was identified (p=0.22, R=−0.0951). Conclusions The findings suggest a greater percentage of all BCHIs that are conducted are seen first at a BCHI centre initially rather than seen elsewhere. This could represent a potential geographical barrier to accessing BCHI services for patients not living in the locality of a non-BCHI providing centre. Future work is required to better understand BCHI service barriers on a national level and to identify methods to ensure equitable access for all.