Long-term multidimensional outcomes of China’s national cochlear implant assistance programme over twenty-one years

Abstract Long-term evidence on publicly funded cochlear implantation programmes remains limited, particularly regarding recipients’ sustained functional, rehabilitative, educational, social and quality-of-life outcomes in real-world settings. This study aimed to evaluate these multidimensional outcomes and identify implementation gaps among recipients of China’s national cochlear implant assistance programme. We conducted a retrospective cross-sectional study of 238 programme participants implanted between 2002 and 2023 in Chongqing, China. Data covered auditory-verbal function, quality of life, education, employment, device use and rehabilitation continuity. Of 238 participants, 222 (93.3%) were children and 16 (6.7%) adults. Continued device use was reported by all adults and 214 children (96.4%). Auditory-verbal outcomes were generally favourable. Among children, 166 (74.8%) attended mainstream schools, but only 76 (34.2%) kept up independently, and 118 (53.2%) had discontinued rehabilitation. Common barriers included classroom noise, inadequate teacher training and device-related social exclusion. Better quality of life was associated with auditory-verbal performance, classroom learning, mainstream placement, daily device use, family background and rehabilitation continuity. The programme was associated with sustained device use, functional benefit and educational participation, but gains did not consistently translate into classroom inclusion or reduced family burden. Long-term value depends on rehabilitation, school support and aftercare.