Provider Perceptions Versus Observed Impacts of Social Determinants on Pediatric Cochlear Implant Follow-up

Lower income and immigration status were associated with reduced follow-up among CI recipients, aligning with provider expectations. However, patients from lower-income urban areas required more frequent follow-ups in the long term, possibly due to poorer hearing outcomes or limited access to local providers. Providers had a negative bias regarding the influence of primary household language, insurance status, and race. While these factors may be associated with lower income and immigration status, they were not directly linked to follow-up adherence. These findings highlight the importance of identifying patients with established risk factors, such as low household income, immigration status, and geographic distance from treatment centers, and proactively engaging their families in discussions about potential barriers to follow-up care and involving social workers to help address these challenges to improve postsurgical follow-up adherence.