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[Pediatric cost-benefit analysis].

H Schulze-Gattermann1, A Illg, A Lesinski-Schiedat

  • 1Dräger Medical AG & Co. KGaA, Lübeck. heide.schulze-gattermann@draeger.com

Laryngo- Rhino- Otologie
|June 12, 2003
PubMed
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Pediatric cochlear implantation offers a favorable cost-benefit ratio compared to hearing aids, especially for children under 2 years old. Early implantation, particularly before age 2, is recommended for prelingually deafened children from a societal perspective.

Area of Science:

  • Pediatric audiology and otolaryngology
  • Health economics and outcomes research
  • Developmental pediatrics

Background:

  • Evaluating the cost-benefit ratio of pediatric cochlear implantation (CI) versus hearing aids (HA) for congenital and prelingual deafness.
  • Focusing on the payer's perspective to analyze educational and associated costs relative to age at implantation.

Purpose of the Study:

  • To compare the cost-benefit ratio of pediatric cochlear implantation with hearing aids in deaf children.
  • To verify if educational costs increase with age at implantation and if they can be lower than hearing aid costs.

Main Methods:

  • Comparison of four groups: children implanted at 0-1.9 years, 2-3.9 years, 4-6.9 years, and deaf children using hearing aids.
  • Analysis from the perspective of sick funds and public authorities, covering medical, indirect, and educational costs up to age 16.

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  • Educational settings were used as a measure of benefit.

    • Main Results:

    • Total costs for pediatric cochlear implant users ranged from $43,300 to $129,000, while hearing aid users incurred costs of $148,600.
    • Educational costs were higher for implanted children in older age groups (4-6.9 years) compared to younger groups, largely due to mainstream schooling.
    • Overall societal/payer costs were DM 271,000 (implanted <2 yrs), DM 334,000 (implanted 2-3.9 yrs), DM 348,000 (implanted 4-6.9 yrs) vs. DM 313,000 (hearing aids).

    Conclusions:

    • Pediatric cochlear implantation demonstrates positive cost-benefit ratios compared to hearing aids, with benefits varying by age at implantation.
    • Implantation before age 2 is particularly recommended for prelingually deafened children from a societal/payer viewpoint.
    • Implantation between ages 2-3.9 years is educationally justifiable, while later implantations require individualized assessment.