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Economic evaluation of newborn hearing screening: modelling costs and outcomes
Franz Hessel1, Eva Grill, Petra Schnell-Inderst
1Institute for Health Care Management, University of Duisburg-Essen, Germany. franz.hessel@uni-essen.de
Insights
Universal newborn hearing screening offers better outcomes despite higher initial costs. Early detection through universal screening is recommended for improved diagnosis and treatment of hearing disorders in infants.
Area of Science:
- Health Technology Assessment
- Public Health Policy
- Pediatric Audiology
Background:
- Newborn hearing disorders affect 1-3 per 1,000 infants.
- Early diagnosis and treatment are critical for developmental outcomes.
- Current European healthcare systems lack widespread universal newborn hearing screening.
Purpose of the Study:
- To evaluate the scientific evidence for newborn hearing screening programs.
- To compare the medical outcomes and costs of different screening strategies (universal, risk-based, none).
- To assess the cost-effectiveness of various newborn hearing screening approaches.
Main Methods:
- A comprehensive literature search identified relevant studies.
- Data on medical outcomes, costs, and cost-effectiveness were extracted.
- A Markov model was utilized to calculate cost-effectiveness ratios.
Main Results:
- Universal screening costs €2.0 million for 100,000 newborns over ten years, compared to €1.0 million for risk screening and €0.6 million for no screening.
- Costs per detected case were €13,395 (universal), €6,715 (risk), and €4,125 (none).
- Universal screening detected 72% of cases by 6 months, versus 43% for risk screening and 13% for no screening.
Conclusions:
- A limited number of low-quality economic studies exist.
- Universal newborn hearing screening demonstrates reasonable cost-effectiveness.
- Universal screening is recommended due to its higher detection rates and improved outcomes.
Objectives:
The prevalence of newborn hearing disorders is 1-3 per 1,000. Crucial for later outcome are correct diagnosis and effective treatment as soon as possible. With BERA and TEOAE low-risk techniques for early detection are available. Universal screening is recommended but not realised in most European health care systems. Aim of the study was to examine the scientific evidence of newborn hearing screening and a comparison of medical outcome and costs of different programmes, differentiated by type of strategy (risk screening, universal screening, no systematical screening).
Methods:
In an interdisciplinary health technology assessment project all studies on newborn hearing screening detected in a standardized comprehensive literature search were identified and data on medical outcome, costs, and cost-effectiveness extracted. A Markov model was designed to calculate cost-effectiveness ratios.
Results:
Economic data were extracted from 20 relevant publications out of 39 publications found. In the model total costs for screening of 100,000 newborns with a time horizon of ten years were calculated: 2.0 Mio.euro for universal screening (U), 1.0 Mio.euro for risk screening (R), and 0.6 Mio.euro for no screening (N). The costs per child detected: 13,395 euro (U) respectively 6,715 euro (R), and 4,125 euro (N). At 6 months of life the following percentages of cases are detected: U 72%, R 43%, N 13%.
Conclusions:
A remarkable small number of economic publications mainly of low methodological quality was found. In our own model we found reasonable cost-effectiveness ratios also for universal screening. Considering the outcome advantages of higher numbers of detected cases a universal newborn hearing screening is recommended.
