China Cochlear Implant for 30 Years: Epidemiology, Policy Effects and Health Economics Evaluation of Cochlear Implantation in China

The data of this study mainly include basic demographic information, clinical and surgical information, implant product information, regional information and external macro data of cochlear implant patients. Patient-level data include gender, date of birth, date of operation, age of implantation, place of residence, area of operation, type of implantation, type of implant and manufacturer, etc. Regional-level data include population size, age structure, economic development level, per capita disposable income of residents, allocation of medical resources, medical insurance policy, centralized procurement policy, CDPF subsidy policy and coverage of rehabilitation service catalogue in each province; the burden of disease and health economics parameters include the prevalence of severe/very severe hearing loss, disability weight, quality of life utility value, medical expenses, rehabilitation costs, care costs and productivity losses.

Statistical analysis begins with cleaning, de-duplication, missing value processing and logical verification of the original data, and unifying the coding of variables such as region, age, gender, implant type and product model. Descriptive statistical methods were used to analyze the age, gender, region, implant time, implant type and product source distribution of cochlear implant patients in China and provinces from 1995 to 2026, and to describe the change trend of cochlear implant volume, implant rate and penetration rate.

On this basis, combined with the population data of the National Bureau of Statistics of China and the prevalence of severe/extremely severe hearing loss published by the World Health Organization (WHO) or related studies, the cochlear implant penetration rate of different age groups and different genders in the country and provinces is estimated, and the differences between different regions and different populations are compared. The impact of economic and policy factors on the volume and penetration of cochlear implants is further analyzed, taking into account the economic level, medical resources, medical insurance payment, collection policy, CDPF subsidy and rehabilitation service coverage in each region.

For the impact of important policies and major events, we will compare the changes in the number, regional distribution, age structure and product structure of cochlear implants before and after the event, and assess the impact of policies or public health events on the accessibility of cochlear implant services.

In the aspect of health economics analysis, it is proposed to evaluate the disease burden and health benefits of cochlear implant by combining the direct medical cost, rehabilitation cost, care cost, productivity loss, disability lost life year (YLD), disability adjusted life year (DALY) and quality of life improvement caused by severe/very severe deafness. The Markov model is further constructed to simulate the transfer between different health states of patients with cochlear implant and non-implanted or conventional hearing aid intervention, and to measure the cost, health benefit and cost effect of cochlear implant in the whole life cycle, which provides the basis for medical insurance payment, government health resource allocation and hearing health intervention policy.