RT Journal Article
SR Electronic
T1 Costs of different strategies for neonatal hearing screening: a modelling approach
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP F177
OP F181
DO 10.1136/fn.85.3.F177
VO 85
IS 3
A1 Boshuizen, H C
A1 van der Lem, G J
A1 Kauffman-de Boer, M A
A1 van Zanten, G A
A1 Oudesluys-Murphy, A M
A1 Verkerk, P H
YR 2001
UL http://fn.bmj.com/content/85/3/F177.abstract
AB OBJECTIVE To compare the cost effectiveness of various strategies for neonatal hearing screening by estimating the cost per hearing impaired child detected.DESIGN Cost analyses with a simulation model, including a multivariate sensitivity analysis. Comparisons of the cost per child detected were made for: screening method (automated auditory brainstem response or otoacoustic emissions); number of stages in the screening process (two or three); target disorder (bilateral hearing loss or both unilateral and bilateral loss); location (at home or at a child health clinic).SETTING The NetherlandsTARGET POPULATION All newborn infants not admitted to neonatal intensive care units.MAIN OUTCOME MEASURE Costs per child detected with a hearing loss of 40 dB or more in the better ear.RESULTS Costs of a three stage screening process in child health clinics are €39.0 (95% confidence interval 20.0 to 57.0) per child detected with automated auditory brainstem response compared with €25.0 (14.4 to 35.6) per child detected with otoacoustic emissions. A three stage screening process not only reduces the referral rates, but is also likely to cost less than a two stage process because of the lower cost of diagnostic facilities. The extra cost (over and above a screening programme detecting bilateral losses) of detecting one child with unilateral hearing loss is €1500–4000. With the currently available information, no preference can be expressed for a screening location.CONCLUSIONS Three stage screening with otoacoustic emissions is recommended. Whether screening at home is more cost effective than screening at a child health clinic needs further study.