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Screening infants for hearing loss--an economic evaluation
1Department of Economics, Queen Mary and Westfield College, University of London, UK.
Insights
An economic evaluation of infant hearing loss screening found an alternative policy more cost-effective than the conventional approach. However, this alternative screening offers little advantage over no screening, warranting further investigation.
Area of Science:
- Health economics
- Public health policy
- Pediatric audiology
Background:
- Infant hearing loss is a significant concern requiring effective screening.
- Current screening programs face economic scrutiny regarding cost-effectiveness.
Purpose of the Study:
- To conduct an economic evaluation of infant hearing loss screening programs.
- To compare the cost-effectiveness of conventional, alternative, and no-screening policies.
Main Methods:
- Cost-effectiveness analysis using decision analysis modeling.
- Appraisal of three screening policies: conventional, alternative (conditional screening), and no screening.
- Consideration of a 'clue list' to guide conditional screening.
Main Results:
- The alternative screening policy demonstrated lower annual expected costs per unit output (11.13-11.23 pounds) compared to the conventional policy (20.57 pounds).
- The cost per unit output for no screening was comparable to the alternative policy (11.27 pounds).
- Introducing a 'clue list' may increase costs, with uncertain effects.
Conclusions:
- The alternative infant hearing screening policy is more cost-effective than the conventional approach.
- The alternative policy shows minimal cost-effectiveness advantage over no screening.
- Further research is needed to determine the impact of a 'clue list' on screening effectiveness and costs.
Study Objective:
The aim was to carry out an economic evaluation of the programme implemented in one district health authority for the screening of infants for hearing loss.
Design:
The approach taken was a cost-effectiveness analysis using the methodology of decision analysis to model the options appraised: (1) the conventional screening policy was for a health visitor and colleague to screen at 8-9 months, and at 10 months for each child to be seen again by a clinical medical officer for a developmental assessment plus hearing screen if necessary; (2) the alternative policy was for screening to take place at 10 months only if concern is expressed (or if there is a clinical indication) at the developmental assessment; the introduction of a "clue list" was considered; (3) the third option was no screening.
Main Results:
The annual expected cost per unit output was pounds 20.57 for the conventional screening policy, between pounds 11.13 and pounds 11.23 for the alternative policy, and pounds 11.27 for the third option of no screening. Introducing the "clue list" under the alternative screening policy is likely to raise the cost per unit output, but the effects are uncertain.
Conclusions:
The results suggest that the alternative screening policy is more cost-effective than the conventional policy, but has little advantage over not screening at all. The effects of introducing a clue list need further investigation.
