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Some issues relevant to establishing a universal newborn hearing screening program
M P Gorga1, K Preissler, J Simmons
1Boys Town National Research Hospital, Omaha, Nebraska 68131, USA.
Journal of the American Academy of Audiology
|March 23, 2001
Summary
Establishing a universal newborn hearing screening (UNHS) program is cost-effective. Screening newborns using otoacoustic emissions (OAE) followed by auditory brainstem response (ABR) for infants who fail OAE testing is the most economical approach.
Area of Science:
- Audiology
- Public Health
- Healthcare Economics
Background:
- Universal newborn hearing screening (UNHS) programs aim to identify hearing loss early.
- Accurate estimation of test sensitivity and specificity is crucial for program effectiveness.
- Programmatic costs encompass equipment, disposables, personnel, and follow-up testing.
Purpose of the Study:
- To analyze the cost-effectiveness of different UNHS protocols.
- To determine the financial feasibility of implementing UNHS programs in hospitals of varying sizes.
Main Methods:
- Comparative cost analysis of three screening protocols: auditory brainstem response (ABR) alone, otoacoustic emission (OAE) alone, and a combined OAE/ABR approach.
- Estimation of costs based on the number of births per year and inclusion of follow-up testing.
- Review of data from a local UNHS program.
Main Results:
- Otoacoustic emissions (OAE) screening alone is less expensive if follow-up costs are excluded.
- When follow-up is included, the OAE followed by ABR protocol is most cost-effective for programs with at least 400 births annually.
- Per-baby costs are estimated to be under $30, decreasing with increased screening volume.
Conclusions:
- Universal newborn hearing screening can be implemented cost-effectively.
- The combined OAE/ABR protocol offers the lowest cost for programs screening 400 or more infants annually.
- Even with unique program features like audiologist-led screening, costs remain below $30 per infant.