Study for Improvement in Public Policies of Hearing Health in Brazil

• Grant number: 23/10201-5
• Support Opportunities: Research Grants - Research in Public Policies
• Start date: February 01, 2024
• End date: November 30, 2025
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Ricardo Ferreira Bento
• Grantee: Ricardo Ferreira Bento
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Associated scholarship(s): 24/23835-5 - Study to Improve Public Policies for Hearing Health in Brazil, BP.TT; 24/17219-0 - Study to Improve Public Policies on Hearing Health in Brazil, BP.TT

Abstract

Hearing loss affects one out of five individuals in the general population for reasons as exposure to environmental noise, advances in life expectancy, use of ototoxic drugs, work-related diseases, and those of genetic origin.The Brazilian National Health System (Sistema Único de Saúde - SUS) assumed the National Policy for Hearing Health Care through through hearing aids. Authorized centers are in charge for clinical care that entails audiological and otological assessments to confirm if the patient is liable for hearing aids. Patients receive audiological and otological care during the entire time they use hearing aids, all from international brands.However the Government does not cover any aspects of services over the hearing aids after guarantee expires, and thus, patients who resort to the SUS are exposed to the same service pricing policy of the private consumers. They can no afford those services and bounced back to the authorized center on requesting free hearing aids replacements, which is secured by legislation. Therefore, patients are plunged in a vicious cycle with side-effect to delay others in queue to get hearing rehabilitation.Replacements can be requested in case of theft (with copy of the incident report), as of hearing aid technical failure, or progressive hearing loss .One of the restrictive factors to the widespread success of the National Hearing Health Care Policy refers to the Medium and High Complexity Financial Limit (Teto da Média e da Alta Complexidade - teto MAC) available for funding hearing aids, albeit this happen in whole SUS network. This blocking path alone turned additonal challenges for SUS managers to investigate how to maximize the use of resources besides a cap on budget.These authorized centers do not have performance indicators to be provided to public managers, where such metrics could pinpoint continuous improvements by finding means and methods to minimize replacements and to identify the best suppliers of hearing aids, their best models in terms of operating cost and life cycle, just to name few. By extension, they could help in the development of a breed of hearing aids specific-driven to supply the SUS network.In 1999 generic drugs turned offitially into business in Brazil with the main aim to increase the rational drugs consumption by stimulating competition between original drug makers versus generic drug makers. This law encompasses all SUS network must prescribe generics drugs than original drug instead.This research aims to identify the key performance indicators (KPIs) with reference to the services of the National Policy for Hearing Health Care along with one SUS autorized center at the Faculty of Medicine of the University of São Paulo in order to stratify all related aspects to costs, patients, otologists, speech therapists, hearing aids and the companies that supply them. The adoption of a set of KPIs will be proposed to the other centers so that they can better manage public resources arising from this purpose.The secondary objective of this research goes to quantify and qualify all hearing aids features to attend the specifics of SUS demand, as it happens to the generic drugs compared to the original drugs into SUS network. Then we go to design specific-driven hearing aids to SUS network. (AU)