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Cost effectiveness of screening children in health centers
Insights
Paraprofessional aides screened children for health issues, identifying many needing specialist care. Evaluating screening programs must include followup stages for accurate cost-benefit analysis.
Area of Science:
- Community health
- Pediatric screening
- Public health interventions
Background:
- Early detection of developmental, hearing, vision, and articulation issues in children is crucial.
- Screening programs in underserved areas require efficient and cost-effective methods.
- The role of paraprofessionals in healthcare delivery is expanding.
Purpose of the Study:
- To evaluate the effectiveness and cost-efficiency of a screening program utilizing paraprofessional aides in Denver.
- To assess the rate of abnormal findings and subsequent specialist referrals and treatments.
- To determine the importance of followup stages in the economic evaluation of screening initiatives.
Main Methods:
- Paraprofessional aides conducted hearing, vision, articulation, and developmental screenings in four Denver health centers.
- Children with abnormal results were referred to specialists for further evaluation.
- Data on tests performed, abnormal results, specialist evaluations, and treatment recommendations were collected over three months.
Main Results:
- Aides performed 3,183 tests, with 302 (9.5%) yielding abnormal results.
- 146 children were evaluated by specialists, and 95 (65% of those evaluated) received treatment recommendations.
- The cost per aide was $10,937 annually, with costs per test, abnormal result, and treatment decision at $2.87, $30, and $96, respectively.
Conclusions:
- Paraprofessional-led screening is effective in identifying children needing specialist care.
- The cost-effectiveness analysis highlights the need to incorporate followup and treatment adherence.
- Comprehensive evaluation of screening programs must consider the entire patient pathway, not just initial testing.
Abstract:
Aides from poor neighborhoods in Denver, Colo., screened children in four health centers for problems in hearing, vision, articulation, and development, and children with abnormal test results were referred to specialists for evaluation. In 3 months, paraprofessional aides did 3,183 tests, of which 302 yielded abnormal results. In 146 instances, these abnormal results led to the evaluation of the children by a specialist, who recommended treatment in 95 instances. The total annual cost of maintaining one paraprofessional aide was $10,937. The average cost per test performed by such an aide was $2.87, $30 per abnormal test result, and $96 per test resulting in a decision to treat. The results show the importance of considering the later stages of followup in evaluating a screening program.