Title
Costs of different strategies for neonatal hearing screening: A modelling approach
Author
Boshuizen, H.C.
van der Lem, G.J.
de Kauffman-Boer, M.A.
van Zanten, G.A.
Oudesluys-Murphy, A.M.
Verkerk, P.H.
Publication year
2001
Abstract
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 Netherlands Target 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.
Subject
Health
Automated auditory brainstem response
Costs
Hearing
Otoacoustic emissions
Screening
Comparative study
Confidence interval
Cost benefit analysis
Disposable equipment
Economics
Evoked response audiometry
Hearing impairment
Methodology
Newborn
Newborn screening
Prediction and forecasting
Spontaneous otoacoustic emission
Statistical model
Audiometry, Evoked Response
Confidence Intervals
Cost-Benefit Analysis
Deafness
Disposable Equipment
Female
Humans
Infant, Newborn
Male
Models, Economic
Monte Carlo Method
Multivariate Analysis
Neonatal Screening
Otoacoustic Emissions, Spontaneous
Predictive Value of Tests
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http://resolver.tudelft.nl/uuid:dd6f8247-1fa3-4537-af24-309f750a6032
TNO identifier
236320
ISSN
0003-9888
Source
Archives of Disease in Childhood: Fetal and Neonatal Edition, 85 (3)
Document type
article