Factors associated with the care component in the follow-up of people with tinnitus: a comparative analysis between primary and specialty care
1
Department of Speech, Language, and Hearing Sciences, São Paulo State University, Marília, Brazil
2
Graduate Program in Health Sciences and Human Communication, São Paulo State University, Marília, Brazil
3
Human Development and Rehabilitation Department, University of Campinas, Campinas, Brazil
4
Department of Speech, Language, and Hearing Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
5
Graduate Program in Speech, Language, and Hearing Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Tinnitus care requires coordination across the health care network to promote a comprehensive approach1-2. This study aimed to analyze factors related to tinnitus perception, health literacy, and functioning among adults and older adults followed in primary care compared with specialty care.
METHODS:
This cross-sectional study included adults and older adults with tinnitus followed in 12 Primary Care Units and one hearing health referral service in a large Brazilian city (n=350; 290 primary care and 60 specialty care), and received ethical approval. Data were collected using a characterization questionnaire, the Brazilian Economic Classification Criterion (CCEB), the Tinnitus Handicap Inventory (THI), the World Health Organization Disability Assessment Schedule (WHODAS 2.0), and the Short Assessment of Health Literacy for Portuguese-speaking Adults (SAHLPA-18), and analyzed using descriptive and inferential statistics, including logistic regression.
RESULTS:
The study included 350 participants (median age 53 years; IQR: 45–64), predominantly female, with low schooling (median 8.5 years) and high prevalence of chronic conditions, hearing difficulty, and inadequate health literacy (83.7%). Compared with primary care, participants in specialty care showed higher schooling, socioeconomic status, tinnitus impact, and health literacy, as well as greater hearing difficulty, while primary care users presented greater restrictions in social participation. In the final logistic regression model, higher CCEB (OR=1.18; IC 1.11-1.25; p<0.001), THI (OR=1.03; IC 1.01-1.05; p=0.004), and SAHLPA-18 scores (OR=1.35; IC 1.22-1.47; p<0.001 ), hearing difficulty (OR=3.82; IC 1.32-11.03; p=0.013), and absence of prior COVID-19 (OR=5.37; IC 2.41-11.95; p<0.001) were associated with specialty care, indicating that socioeconomic conditions, clinical factors, and health literacy influence access to the care component.
CONCLUSIONS:
Access to specialty care for people with tinnitus was influenced by socioeconomic and clinical conditions and by health literacy, with greater functional vulnerability and inadequate health literacy concentrated in primary care, highlighting inequities and the need to strengthen comprehensive and equitable approaches.
Tinnitus care requires coordination across the health care network to promote a comprehensive approach1-2. This study aimed to analyze factors related to tinnitus perception, health literacy, and functioning among adults and older adults followed in primary care compared with specialty care.
METHODS:
This cross-sectional study included adults and older adults with tinnitus followed in 12 Primary Care Units and one hearing health referral service in a large Brazilian city (n=350; 290 primary care and 60 specialty care), and received ethical approval. Data were collected using a characterization questionnaire, the Brazilian Economic Classification Criterion (CCEB), the Tinnitus Handicap Inventory (THI), the World Health Organization Disability Assessment Schedule (WHODAS 2.0), and the Short Assessment of Health Literacy for Portuguese-speaking Adults (SAHLPA-18), and analyzed using descriptive and inferential statistics, including logistic regression.
RESULTS:
The study included 350 participants (median age 53 years; IQR: 45–64), predominantly female, with low schooling (median 8.5 years) and high prevalence of chronic conditions, hearing difficulty, and inadequate health literacy (83.7%). Compared with primary care, participants in specialty care showed higher schooling, socioeconomic status, tinnitus impact, and health literacy, as well as greater hearing difficulty, while primary care users presented greater restrictions in social participation. In the final logistic regression model, higher CCEB (OR=1.18; IC 1.11-1.25; p<0.001), THI (OR=1.03; IC 1.01-1.05; p=0.004), and SAHLPA-18 scores (OR=1.35; IC 1.22-1.47; p<0.001 ), hearing difficulty (OR=3.82; IC 1.32-11.03; p=0.013), and absence of prior COVID-19 (OR=5.37; IC 2.41-11.95; p<0.001) were associated with specialty care, indicating that socioeconomic conditions, clinical factors, and health literacy influence access to the care component.
CONCLUSIONS:
Access to specialty care for people with tinnitus was influenced by socioeconomic and clinical conditions and by health literacy, with greater functional vulnerability and inadequate health literacy concentrated in primary care, highlighting inequities and the need to strengthen comprehensive and equitable approaches.
| eISSN: | 2654-1459 |
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