The costs of early hearing screening in England and Wales

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Abstract
A survey was carried out in 10 centres in England and Wales to determine the costs of hearing screening in the first year of life. The screens that were studied were targeted neonatal, universal neonatal, and the health visitor distraction test (HVDT) or alternative surveillance. Valid data were available from five centres for targeted neonatal screening (TNS), three for universal neonatal screening (UNS), and nine for the HVDT, although only five of the HVDT screens had valid data for follow up costs. The neonatal costs were consistent across the centres surveyed, whereas those for the HVDT screen varied considerably. The mean service costs for TNS, UNS, and the HVDT at 1994 prices were £5052, £13 881, and £24 519 for a standardised district of 1000 live births. Three conclusions seem justified. Firstly, UNS need not be prohibitively expensive as it costs considerably less than HVDT screening. Secondly, TNS appears to be a relatively inexpensive way of improving the age of identification of a proportion of the congenitally hearing impaired. Thirdly, given the published yields for UNS and the HVDT, the results indicate that UNS offers the most cost effective overall approach with alternative systems in place to identify late onset permanent hearing losses. In England and Wales the cost of universal neonatal hearing screening was found to be considerably less than that of the HVDT done at 8 months of age TNS screening was found to be a relatively inexpensive way of improving the age of identification for a proportion of the congenitally hearing impaired From published yields, the results suggest that universal neonatal hearing screening offers the most cost effective approach to early identification of the congenitally hearing impaired