Brazil reinforces its public standards for cochlear implants

Regulation

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Brazilian Ministry of Health Decree 2.776 of December 18, 2014, has established new standards for the surgical treatment of deafness through the Sistema Único de Saúde, the country’s publicly funded health system.

The new regulation supersedes Decree 1.278 in force since 1999, which set the rules for cochlear implants in the Brazilian public sector for 15 years. Decree 2.776 includes a range of new procedures (now 24 instead of 4), including simultaneous and sequential bilateral cochlear implant in children aged under 7 years, and in teenagers and adults with post-lingual deafness.

For the former group, bilateral CI depends on several conditions, among which not benefiting from bimodal fitting (CI+HA), scoring 50% or less on open-set sentences testing, and adequate rehabilitation conditions in the city of residency. Furthermore, teenagers and adults who meet the criteria have to undergo sequential CI, since the first implant must have been proven effective before implanting the second. Another improvement is a 6-year free-of-charge warranty for all devices’ external parts, and sound processor replacement after six years. The decree also includes bone-anchored hearing aids in the government’s hearing health policy.

Besides new procedures, the new decree also obliges CI hospitals to request a new qualification with requirements exceeding those of the former regulation. For instance, the Brazilian Ministry of Health aims to increase knowledge in hospitals with little CI experience. Hospitals with less than 10 years’ qualification in the CI government program or less than 240 CIs need to qualify their otolaryngology surgeons with a 60-hour course on CIs and bone-anchored HAs, an 80-hour practical internship, and the follow-up of 20 surgeries (10 in adults and 10 in children).

Source: Audiology Infos Brazil

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