title: Estimated cost-effectiveness of active middle-ear implantation in hearing-impaired patients with severe external otitis.
abstract: OBJECTIVE
  To determine the cost-effectiveness of middle-ear implantations in hearing-impaired patients with severe external otitis in the Netherlands.
  
  
  METHODS
  Cost-effectiveness analysis, using single-subject repeated measures of quality of life and total cost determinations.
  
  
  METHODS
  Hospital based. Patients Moderately to severely sensorineurally hearing-impaired patients (n = 21) with severe chronic external otitis, eligible to receive a middle-ear implant. Main Outcome Measure Cost per quality-adjusted life-year (QALY), based on scores of the Medical Outcomes Study Short-Form Health()Survey (SF-36) generic quality of life questionnaire. Only direct costs were included in cost calculation of middle-ear implantation.
  
  
  RESULTS
  Mean health utility gain was 0.046 (0.012-0.079) (P = .01) measured at the mental component of the SF-36. With a mean profitable time of 19.4 years and an overall cost of euro 14,354, minimal cost-effectiveness of middle-ear implantation was euro 16,085/QALY.
  
  
  CONCLUSIONS
  Based on the cost per QALY, middle-ear implantation proved to be a cost-effective and justified health care intervention in the Netherlands.
authors.affiliation: Department of Otorhinolaryngology, University Medical Center St Radboud Nijmegen, Nijmegen, the Netherlands. a.snik@kno.umcn.nl
authors.forename: Ad F M
authors.initials: AF
authors.lastname: Snik
authors.forename: Noortje T L
authors.initials: NT
authors.lastname: van Duijnhoven
authors.forename: Emmanuel A M
authors.initials: EA
authors.lastname: Mylanus
authors.forename: Cor W R J
authors.initials: CW
authors.lastname: Cremers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003362:Cost-Benefit Analysis; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009998:Ossicular Prosthesis / Q000191:economics*; D010032:Otitis Externa / Q000150:complications*; D011446:Prospective Studies; D011788:Quality of Life