Using Supply and Demand to Identify Shortages in the Hearing Health Care Professional Workforce.

Abstract

Hearing loss is a significant public health issue, affecting 23% of individuals 12 years and older in the US. While hearing loss can be efficaciously treated in many cases, shortages in the supply of hearing health care (HHC) professionals may limit uptake. To quantify the US HHC professional workforce from 2012 to 2022 and identify areas experiencing HHC professional shortages in 2019. In this quality improvement study, raw data from the National Plan and Provider Enumeration System were transformed to create a state- and county-level database of HHC professionals, including audiologists and hearing instrument specialists from 2012 to 2022, to assess HHC workforce supply. To assess HHC workforce demand, 2019 state- and county-level hearing loss prevalence data from Sound Check and US Census population data were used. Shortage areas were determined by comparing these measures of supply and demand in 2019. The audiologists and hearing instrument specialists included possessed National Provider Identifiers, allowing them to bill public and private insurance in the US. The data were analyzed between August 2022 and December 2024. Potential-shortage areas were defined using a threshold of 1 or fewer audiologists per 3500 individuals with hearing loss, and shortage areas were defined using a threshold of 1 or fewer HHC professionals per 3500 individuals with hearing loss. From 2012 to 2022, the number of HHC professionals in the US increased from 16 770 to 30 704, or more than 83%. By the end of 2022, 72.4% of the HHC workforce were audiologists, and 27.6% were hearing instrument specialists, compared to 82.6% and 17.4%, respectively, in 2012. In June 2019, 75.0% of US counties were identified as shortage counties, and these counties were disproportionately rural. Ten states, primarily in the South Census region, are identified as shortage states. This quality improvement study showed that despite workforce growth, many areas of the US continue to experience shortages of HHC professionals, disproportionately affecting rural populations. Addressing these shortages may improve access to care for individuals with hearing loss.