Costs of screening children for hearing disorders and delivery of hearing aids in China.
BACKGROUND
The burden of disease of hearing disorders among children is high, but a large part goes undetected. School-based screening programs in combination with the delivery of hearing aids can alleviate this situation, but the costs of such programs are unknown.


OBJECTIVE
To evaluate the costs of a school-based screening program for hearing disorders, among approximately 216,000 school children, and the delivery of hearing aids to 206 children at three different care levels in China.


METHODS
In a prospective study design, screening and hearing aid delivery costs were estimated on the basis of program records and an empirical assessment of health personnel time input. Household costs for seeking and undergoing hearing health care were collected with a questionnaire, administered to the parents of the child. Data were collected at three study sites representing primary, secondary and tertiary care levels.


RESULTS
Total screening and hearing aid delivery costs ranged between RMB70,000 (US$9,000) and RMB133,000 (US$17,000) in the three study sites. Health care cost per child fitted ranged from RMB5,900 (US$760) at the primary care level, RMB7,200 (US$940) at the secondary care level, to RMB8,600 (US$1,120) at the tertiary care level. Household costs were only a small fraction of the overall costs. Cost per child fitted ranged between RMB1,608 and RMB2,812 (US$209-US$365), depending on perspective of analysis and study site. The program was always least costly in the primary care setting.


CONCLUSIONS
Hearing screening and the delivery of hearing aids in China is least costly in a primary care setting. Important questions remain concerning its implementation.
Department of Public Health, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands. r.baltussen@sg.umcn.nl
Rob
R
Baltussen
Ju
J
Li
Li Dong
LD
Wu
Xiao Hui
XH
Ge
Bai Yu
BY
Teng
Xi Bin
XB
Sun
Rui
R
Han
Xiao Li
XL
Wang
Bradley
B
McPherson
D002648:Child; D002681:China / Q000453:epidemiology; D005260:Female; D006302:Health Services Research; D006310:Hearing Aids / Q000191:economics*; D006311:Hearing Disorders / Q000175:diagnosis* / Q000191:economics* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics*; D011446:Prospective Studies; D012572:School Health Services / Q000191:economics*; D011795:Surveys and Questionnaires