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Cost-effectiveness analysis of a national neonatal hearing screening program in China: conditions for the scale-up
Ruoyan Gai Tobe1, Rintaro Mori, Lihui Huang
1School of Public Health, Shandong University, Jinan, Shandong Province, China.
Insights
China
Area of Science:
- Public Health
- Health Economics
- Audiology
Background:
- China's Ministry of Health recommended nationwide neonatal hearing screening in 2009.
- Screening was previously limited to select urban hospitals.
Purpose of the Study:
- To compare the cost-effectiveness and health outcomes of five neonatal hearing screening strategies in China.
- To inform the national rollout of hearing screening programs.
Main Methods:
- A decision-analytic model simulated live births in China.
- Evaluated interventions: universal/targeted Otoacoustic Emission (OAE) and Automated Auditory Brainstem Response (AABR), and no screening.
- Calculated Disability-Adjusted Life Years (DALYs) for health effects.
Main Results:
- The optimal scale-up strategy begins with targeted OAE screening.
- Expansion to universal OAE and then universal OAE plus AABR is recommended.
- Screening accessibility significantly impacts strategy effectiveness.
Conclusions:
- Expanding access to screening, diagnosis, and intervention is crucial for cost-effectiveness and optimal health outcomes.
- This phased approach supports the national hearing health plan.
- Strategic implementation can maximize benefits for a larger population.
Background:
In 2009, the Chinese Ministry of Health recommended scale-up of routine neonatal hearing screening - previously performed primarily only in select urban hospitals - throughout the entire country.
Methods:
A decision analytical model for a simulated population of all live births in china was developed to compare the costs and health effects of five mutually exclusive interventions: 1) universal screening using Otoacoustic Emission (OAE) and Automated Auditory Brainstem Response (AABR); 2) universal OAE; 3) targeted OAE and AABR; 4) targeted OAE; and 5) no screening. Disability-Adjusted Life Years (DALYs) were calculated for health effects.
Results And Discussion:
Based on the cost-effectiveness and potential health outcomes, the optimal path for scale-up would be to start with targeted OAE and then expand to universal OAE and universal OAE plus AABR. Accessibility of screening, diagnosis, and intervention services significantly affect decision of the options.
Conclusion:
In conclusion, to achieve cost-effectiveness and best health outcomes of the NHS program, the accessibility of screening, diagnosis, and intervention services should be expanded to reach a larger population. The results are thus expected to be of particular benefit in terms of the 'rolling out' of the national plan.
