Status of the Newborn Hearing Screening in the 4-Months Age National Infant Health Checkup in Korea: A Nationwide
Jiwon Chang1, Su-Kyoung Park2, Gi Jung Im3
1Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Kangnam Sacred-Heart Hospital, Seoul, Korea. brune77@naver.com.
Insights
The newborn hearing screening (NHS) performing rate in South Korea increased to 88.9% by 2016. Referral rates varied significantly based on infant health and socioeconomic factors, highlighting disparities in hearing care access.
Area of Science:
- Public Health
- Pediatrics
- Audiology
Background:
- The National Health Screening Program for Infants and Children (NHSPIC) in South Korea includes newborn hearing screening (NHS).
- Data from the National Health Insurance Service (NHIS) database provides insights into screening participation and outcomes.
- Understanding trends in NHS is crucial for early detection of hearing impairment in infants.
Purpose of the Study:
- To analyze newborn hearing screening (NHS) results from the 4-month NHSPIC.
- To examine trends in NHS performance and referral rates over seven years (2010-2016).
- To identify factors influencing NHS participation and outcomes, including infant health and socioeconomic status.
Main Methods:
- Analysis of a National Health Insurance Service (NHIS) database for infants aged 4 months from 2010 to 2016.
- Inclusion of data from the National Health Screening Program for Infants and Children (NHSPIC).
- Statistical analysis of hearing questionnaire results, physical examinations, and demographic factors.
Main Results:
- The overall NHS performing rate increased from 79.1% in 2010 to 88.9% in 2016.
- Premature infants and those with NICU stays showed higher NHS performing rates (93.4% and 91.7% respectively in 2016).
- Referral rates were higher for premature infants (1.4%), NICU-hospitalized infants (2.3%), and infants in Medical Aid programs (3.8%) compared to the general population (0.6%).
Conclusions:
- The NHS performing rate in South Korea has shown a positive upward trend.
- Significant disparities in NHS referral rates exist based on infant health status and household income.
- Findings support the development of targeted policies and customized hearing care services to address socioeconomic inequalities.
Background:
The aims of this study are to review data on 4-months age National Health Screening Program for Infants and Children (NHSPIC) using a National Health Insurance Service (NHIS) database, and to analyze the newborn hearing screening (NHS) results and related characteristics of the 4-months NHSPIC for 7 years in South Korea.
Methods:
We analyzed a NHIS database of infants who had participated in the 4-month age NHSPIC from 2010 to 2016. According to the results of hearing questionnaires and physical examination, we analyzed the outcomes of NHS and related infantile and socioeconomic factors.
Results:
Among 3,128,924 of total eligible infants in Korea between the year 2010 and 2016, 69.2% (2,164,621 infants) conducted 4-months age NHSPIC, and 94.4% (2,042,577 infants) of which performed hearing questionnaires regarding NHS. Among the total hearing examinees, premature infants accounted for 3.6%, infants who were hospitalized in the neonatal intensive care unit (NICU) for more than 5 days accounted for 5.6%, and infants with head and neck abnormalities were 0.6%. The NHS performing rate was 79.1% for total hearing examinees in 2010, but gradually increased to 88.9% in 2016. The NHS performing rate in 2016 was 93.4% for premature infants, 91.7% for NICU hospitalized babies. The mean referral rate was 0.6% for total hearing examinees, 1.4% for premature infants, and 2.3% for NICU hospitalized babies. When we analyzed the NHS performing rate and the referral rate according to the household income level, the NHS performing rate of infants in Medical Aid programs was the lowest as 65.6%, and the NHS performing rates in other five levels of NHIS was higher ranging between 85.1% to 86.0%. The referral rate of infants in the Medical Aid program (3.8%) was significantly higher than those of infants in other classes (1.10-1.25%).
Conclusion:
The estimated overall NHS performing rate in Korea gradually increased and was 88.9% in 2016. The overall referral rate was low as 0.6%, and it was significantly different depending on the infant's health condition and household income levels. We assume that our finding would help to establish policies managing hearing impaired children, and to develop the customized hearing care service programs considering the household economic levels.
