Hearing loss can have a variety of causes. The most frequent type is sensorineural hearing loss. It is not reversible, i.e. it cannot be treated by surgery or medication. Acquired sensorineural hearing loss is due to aging, exposure to noise and infections. It can also occur congenitally.

For most conditions a hearing technology is the only help. When fitted and used appropriately it can greatly improve hearing, yet in most cases it will not restore hearing the way the person experienced it before. Health care for persons with hearing loss is provided by audiologists, ear-nose-throat doctors and rehabilitation specialists (e.g. logopedics). Medical research and technological development guide how specialists are trained to conduct diagnosis and treatment.

Although today’s hearing aids are highly advanced, very few persons with hearing loss use them (in Europe only 20%). This cost of untreated hearing loss in Europe is estimated at 213 billion Euro. Hearing aid use differs significantly among western countries. Therefore, an important goal of this research is to compare different health care systems and to study what exactly happens during communication in health care encounters. There are three central encounters in all western health care systems, namely the medical ear examination, the diagnostic testing of the kind and degree of hearing loss, and subsequently the selection, fitting and re-fitting of hearing aids. Western health care systems differ in the way professional services are organized and the technological devices are distributed. Health care systems also differ in how they are financed, how the patient accesses them, waiting time for certain services, the range of hearing aids a patient can choose from, and the amount of co-payment.

One reason for the significant national differences in hearing aid use seems to lie in how the services and availability of technologies are organized. Persons with hearing loss experience such differences in actual communication with audiological professionals. Therefore it is important to study these encounters.