Cost‐effectiveness and test‐performance factors in relation to universal newborn hearing screening

Abstract

The first portion of this paper reviews current understanding of the cost of universal newborn hearing screening (UNHS), including capital and operating expenses, as well as the costs for follow-up testing on infants who do not pass the hearing screening test in the perinatal period. Capital expenses include the cost of equipment. Operating expenses include the costs for disposables and personnel. Follow-up costs relate to the diagnostic testing that must be performed in order to determine hearing status in those infants who do not pass the newborn hearing screening test. This section is followed by a more theoretical approach, in which test performance, prevalence, program costs, and "costs of hearing loss" are combined in a model that includes all costs of hearing loss, including screening, follow-up testing, and costs (benefits) associated with identifying hearing loss early in life. While some of the model's cost/benefit assumptions may be incorrect, the general approach of taking into account both costs and benefits provides a framework for evaluating the utility of UNHS in a more global manner. Model assumptions (costs, benefits, prevalence, sensitivity, specificity) can be changed to values deemed more appropriate, but the general approach is still informative. With the present assumptions, it is shown that initially, the costs of UNHS exceed its benefits. However, after only four years of operation, UNHS programs will result in a net savings to society. These savings increase rapidly, reaching a maximum annual benefit of seven billion dollars 75 years after initiation of the program, which is also the societal benefit for all years thereafter.

Using Benefit-Cost Ratio to Select Universal Newborn Hearing Screening Test Criteria

“…The cost of a UNHS program that utilizes a one-step DPOAE screening was based on data reported by Gorga et al (2001) and Gorga and Neely (2003). Costs of a two-step screening including AABR are included in subsequent sections.…”

Estimulación de la atención sostenida en el neonato previo al tamizaje auditivo, reducción de falsos positivos

“…8 El diagnóstico precoz ahorra los costos de la intervención intensiva del habla y del lenguaje y los servicios educativos especiales. [9][10][11][12] Actualmente, las pruebas de emisión otoacústicas (OAE) y/o respuesta auditiva del tallo cerebral (ABR) se utilizan como herramientas de detección en programas de tamizaje auditivo en recién nacidos. La prueba OAE es rápida, fácil de realizar y asequible, convirtiéndola en una excelente herramienta a utilizar en los programas de tamiz auditivo en recién nacidos.…”

What Contribution Did Economic Evidence Make to the Adoption of Universal Newborn Hearing Screening Policies in the United States?

“…Similarly, Gorga and Neely in 2003 [ 61 ] assumed a US$1,000,000 lifetime present value cost of PCHL, which included both higher education costs and lower lifetime earnings (productivity costs) taken from Mohr et al [ 58 ]. In addition, Gorga and Neely assumed that EHDI would result in a 100% reduction in costs associated with PCHL [ 61 ].…”