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Ultrasound screening of the neonatal hip: cost-benefit analysis
I Bralić1, J Vrdoljak, L Kovacić
1Trogir Health Center, Trogir, Croatia.
Insights
Introducing ultrasound screening for developmental dysplasia of the hip in Croatia is economically justified. This cost-effective approach offers significant annual savings compared to current diagnostic methods.
Area of Science:
- Public Health
- Health Economics
- Pediatric Imaging
Background:
- Developmental dysplasia of the hip (DDH) requires early detection for effective treatment.
- Croatia's healthcare system faces economic considerations for new screening programs.
Purpose of the Study:
- To evaluate the economic justification of implementing ultrasound screening for DDH in Croatia.
- To compare the costs and benefits of ultrasound screening versus existing diagnostic approaches.
Main Methods:
- Cost-benefit and net benefit analyses were performed.
- Screening costs included training and examination fees.
- Benefits were calculated based on reduced late-stage treatment costs.
Main Results:
- Total annual screening costs estimated at $329,537.80, including $31,035.90 for training.
- Ultrasound screening could save $195,336.50 annually.
- Treatment costs without screening were 1.6 times higher than screening costs.
Conclusions:
- Ultrasound screening for DDH in neonates is economically viable in Croatia.
- The program's cost can be offset by savings from preventing costly late-stage interventions.
Aim:
To explore the economic justification for introducing ultrasound screening for developmental dysplasia of the hip in Croatia.
Methods:
The analysis was based on the two formulas: that cost-benefit equals benefit/cost, and that net benefit equals benefit minus cost. Screening costs were expressed as a sum of training costs and fee for ultrasound screening of neonates. The neonatologists' working hours and utilization of ultrasound instruments were expressed by multiplying the number of infants born per year in Croatia (N = 47,792) with the standard time needed for one examination and then dividing the product by the number of employed neonatologists (N = 54) and number of ultrasound instruments (N = 58). The benefit was expressed as a late case treatment costs and screening costs ratio. Savings, which would have resulted from the reduction in expected treatment costs of patients with hip problems at later age, represent the indirect benefit.
Results:
Total hip screening costs would have amounted to US$329,537.80, including the training costs of US$31,035.90. On the average, a neonatologist would spend 71.4 hours screening per year, whereas the instrument utilization would be 64.7 hours. An ultrasound-screening program would save annually US$195,336.50, compared with the existing diagnostic approach. The treatment costs without ultrasound screening were 1.6 times higher than the screening costs. Hospital treatment costs for 165 patients needing endoprosthesis would cover the total screening program in the whole country.
Conclusion:
It is economically justified to introduce ultrasound screening for developmental dysplasia of the hip in neonates in Croatia, a country with transitional and developing economy.