Health-service costs of pediatric cochlear implantation: multi-center analysis

Barton, Garry; Bloor, Karen; Marshall, David; Summerfield, A. Quentin

doi:10.1016/s0165-5876(02)00355-5

Cited by 40 publications

(48 citation statements)

References 10 publications

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“…The analysis covered only the 1-year follow-up of CI. This period is shorter than in most studies, which generally focussed on several years after CI, indeed up to 73 years in a study reported by Barton et al [2]. This longer follow-up period generates a large part of total costs [2,5,21,24,25].…”

Section: Discussionmentioning

confidence: 84%

“…This prospective study, based on a representative national sample of implanted patients, takes into account the main factors influencing management costs, namely treatment modalities (hospital-based or ambulatory care) and health-care practices. This approach permits a robust economic analysis reflecting the reality of patient management and is a useful adjunct to previously published studies in this area, be they retrospective [2,6,[24][25][26] or model-based [5,13,27]. This study tool place within the context of the current reforms of financing of the healthcare system.…”

Section: Discussionmentioning

confidence: 99%

“…In the face of scarce resources, decision makers are interested not only in the effectiveness of certain healthcare interventions but also in the costs involved. Several studies, in particular in the United Kingdom [2,7,13,17,19,[23][24][25], the United States [12,18,27], Australia [5] and the Netherlands [21], have analysed the costs of cochlear implants. These studies have revealed the costs of CI for healthcare systems, leading to major rethinking in the field of health cost rationalisation.…”

Section: Introductionmentioning

confidence: 99%

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The economics of cochlear implant management in France: a multicentre analysis

et al. 2009

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This study assessed the direct medical cost of cochlear implantation in children and adults in France. A prospective multicentre study involving 19 French University Hospitals included 268 children and 201 adults who were severely to profoundly hearing-impaired. Medical resources utilisation included diagnostic tests, in-patient care, device implants, adverse events and follow-up visits for rehabilitation in the 1st year. The mean costs were 34,686 per child and 31,946 per adult. The cost of device implant represents 64.4% and 68.8% of the total cost for children and adults, respectively. The current reform of financing of the healthcare system requires detailed knowledge of the costs of interventions, hence the costs of cochlear implantation should be factored into resource allocation decisions. Differences in our results compared to other studies can be explained mostly by methodological differences in cost analyses.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The economics of cochlear implant management in France: a multicentre analysis

et al. 2009

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“…studies 190,192,193 . 22,53,55,62,138,192,195,196 . AHL, average hearing level; ICER, incremental cost-effectiveness ratio; QALY, quality-adjusted life-year.…”

Section: Reliability Of Cochlear Implantsmentioning

confidence: 99%

The effectiveness and cost-effectiveness of cochlear implants for severe to profound deafness in children and adults: a systematic review and economic model

Bond

Mealing²,

Anderson³

et al. 2009

Health Technol Assess

232

227

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How to obtain copies of this and other HTA programme reports An electronic version of this publication, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable CD-ROM is also available (see below).Printed copies of HTA monographs cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our Despatch Agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. Objectives: To investigate whether it is clinically effective and cost-effective to provide (i) a unilateral cochlear implant for severely to profoundly deaf people (using or not using hearing aids), and (ii) a bilateral cochlear implant for severely to profoundly deaf people with a single cochlear implant (unilateral or unilateral plus hearing aid). . Quality of life measured with generic and disease-specific instruments or by interview mostly showed significant gains or positive trends from using cochlear implants. The Markov model base-case analysis estimated that, for prelingually profoundly deaf children, the incremental cost-effectiveness ratio (ICER) for unilateral implantation compared with no implantation was £13,413 per quality-adjusted life-year (QALY). Assuming the utility gain for bilateral implantation is the same for adults and children, the ICERs for simultaneous and sequential bilateral implantation versus unilateral implantation were £40,410 and £54,098 per QALY respectively. For postlingually sensorineurally profoundly deaf adults, the corresponding ICERs were £14,163, £49,559 ...

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“…Despite many demonstrations of the efficacy of implantation, and despite implantation having been routine in many countries for more than a decade, questions about effectiveness continue to be asked by parents, educators, clinicians, and commentators, as well as by the policy makers who commission health care. The questions arise because of the high initial and ongoing cost of implantation to systems of health care (Barton, Bloor, Marshall, & Summerfield, 2003) and because of controversies associated with providing an elective surgical intervention to a deaf child (e.g. Balkany, Hodges, & Goodman, 1998;Lane & Bahan, 1999;Rubinstein, 2002).…”

Section: Setting Of the Studymentioning

confidence: 99%

Hearing-Impaired Children in the United Kingdom, I: Auditory Performance, Communication Skills, Educational Achievements, Quality of Life, and Cochlear Implantation

et al. 2006

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Objectives: The objectives of this study were to identify variables which are associated with differences in outcome among hearing-impaired children, and to control those variables while assessing the impact of cochlear implantation. Study design:In a cross-sectional study, the parents and teachers of a representative sample of hearing-impaired children were invited to complete questionnaires about children's auditory performance, spoken communication skills, educational achievements, and quality of life. Multiple regression was used to measure the strength of association between these outcomes and variables related to the child (average hearing level, age at onset of hearing impairment, age, gender, number of additional disabilities), the family (parental occupational skill level, ethnicity, and parental hearing status), and cochlear implantation.Results: Questionnaires were returned by the parents of 2858 children, 468 of whom had received a cochlear implant, and by the teachers of 2241 children, 383 of whom had received an implant. Across all domains, reported outcomes were better for children with fewer disabilities in addition to impaired hearing. Across most domains, reported outcomes were better for children who were older, female, with a more favourable average hearing level, with a higher parental occupational skill level, and with an onset of hearing-impairment after 3 years. When these variables were controlled, cochlear implantation was consistently associated with advantages in auditory performance and spoken communication skills, but less consistently associated with advantages in educational achievements and quality of life.Significant associations were found most commonly for children who were younger than 5 years when implanted, and had used implants for more than 4 years. TheseHearing-impaired children in the UK, I. 2 children, whose mean (pre-operative, un-aided) average hearing level was 118 dB, performed at the same level as non-implanted children with average hearing levels in the range from 80 dB to 104 dB, depending on the outcome measure. Conclusion:When rigorous statistical control is exercised in comparing implanted and non-implanted children, paediatric cochlear implantation is associated with reported improvements both in spoken communication skills and in some aspects of educational achievements and quality of life, provided that children receive implants before 5 years of age.(342 words)

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Health-service costs of pediatric cochlear implantation: multi-center analysis

Cited by 40 publications

References 10 publications

The economics of cochlear implant management in France: a multicentre analysis

The economics of cochlear implant management in France: a multicentre analysis

The effectiveness and cost-effectiveness of cochlear implants for severe to profound deafness in children and adults: a systematic review and economic model

Hearing-Impaired Children in the United Kingdom, I: Auditory Performance, Communication Skills, Educational Achievements, Quality of Life, and Cochlear Implantation

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