Effectiveness of the National Health Screening Program for Infants and Children in Detecting Neurodevelopmental Disorders: A Nationwide Population-Based Analysis
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Published on: September 1, 2018
Seong Woo Kim1, Na Yoon Yoo1, Yeji Kim2
1Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Insights
The National Health Screening Program for Infants and Children (NHSPIC) effectively aids in the early diagnosis of neurodevelopmental disorders (NDDs). Positive screening findings significantly correlate with a higher risk for various NDDs, highlighting the program
Area of Science:
- Pediatric Health
- Developmental Pediatrics
- Public Health Policy
Background:
- Neurodevelopmental disorders (NDDs) require early identification for effective intervention.
- The National Health Screening Program for Infants and Children (NHSPIC) in South Korea aims to detect developmental issues early.
- Evaluating the NHSPIC's effectiveness in diagnosing NDDs is crucial for public health strategies.
Purpose of the Study:
- To assess the NHSPIC's role in the early diagnosis of seven specific neurodevelopmental disorders.
- To analyze the association between positive NHSPIC findings and the subsequent diagnosis of NDDs.
Main Methods:
- Utilized data from South Korea's National Health Insurance Database for children born between 2011-2018.
- Included children who completed the first four stages of the NHSPIC.
- Employed 1:1 propensity score matching to compare children with positive vs. negative screening findings (n=82,138 per group).
Main Results:
- Children with positive NHSPIC findings had a significantly higher risk for all seven studied NDDs.
- Highest risks observed for Autism Spectrum Disorder (HR 19.70) and Intellectual Disability (HR 17.11).
- Specific NHSPIC stages demonstrated utility in detecting particular NDDs, with varying Hazard Ratios (HRs) for each disorder.
Conclusions:
- Developmental screening within the NHSPIC is instrumental in the early diagnosis of NDDs.
- The study provides evidence supporting the NHSPIC's importance in child health.
- Findings can inform and improve policies concerning child health screenings and NDD detection.
Objective:
To evaluate the effectiveness of the National Health Screening Program for Infants and Children (NHSPIC) in the early diagnosis of neurodevelopmental disorders (NDDs) utilizing data from the National Health Insurance Database of South Korea.
Methods:
We enrolled children born between 2011 and 2018 who completed the first to fourth stages of the NHSPIC. A positive finding was defined as a recommendation for further evaluation during one or more stages. Participants were categorized into the positive and negative finding groups. Following 1:1 propensity score matching, 82,138 participants were assigned to each group.
Results:
Comparative analysis revealed that participants with positive findings exhibited a higher risk of developing all seven NDDs, particularly for autism spectrum disorder (hazard ratio [HR], 19.70; 95% confidence interval [CI], 17.48-22.20), intellectual disability (HR, 17.11; 95% CI, 14.69-19.93), developmental language disorder (HR, 11.74; 95% CI, 10.73- 12.84), and cerebral palsy (HR, 11.34; 95% CI, 8.67-14.84). The HR for learning disability was 4.31 (95% CI, 2.94-6.34), whereas attention-deficit hyperactivity disorder had an HR of 3.57 (95% CI, 3.37-3.78). Tic disorder had the lowest HR (HR, 1.64; 95% CI, 1.48-1.82). Additionally, HRs were calculated for each NHSPIC stage, demonstrating the utility of specific stages in the early detection of each NDD.
Conclusion:
Developmental screening tests in the NHSPIC contributed to the early diagnosis of NDDs. This study underscores the significance of the NHSPIC and provides foundational evidence to inform and enhance policies related to child health screenings.
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