title: Economic evaluation of newborn hearing screening: modelling costs and outcomes.
abstract: OBJECTIVE
  The prevalence of newborn hearing disorders is 1-3 per 1,000. Crucial for later outcome are correct diagnosis and effective treatment as soon as possible. With BERA and TEOAE low-risk techniques for early detection are available. Universal screening is recommended but not realised in most European health care systems. Aim of the study was to examine the scientific evidence of newborn hearing screening and a comparison of medical outcome and costs of different programmes, differentiated by type of strategy (risk screening, universal screening, no systematical screening).
  
  
  METHODS
  In an interdisciplinary health technology assessment project all studies on newborn hearing screening detected in a standardized comprehensive literature search were identified and data on medical outcome, costs, and cost-effectiveness extracted. A Markov model was designed to calculate cost-effectiveness ratios.
  
  
  RESULTS
  Economic data were extracted from 20 relevant publications out of 39 publications found. In the model total costs for screening of 100,000 newborns with a time horizon of ten years were calculated: 2.0 Mio.euro for universal screening (U), 1.0 Mio.euro for risk screening (R), and 0.6 Mio.euro for no screening (N). The costs per child detected: 13,395 euro (U) respectively 6,715 euro (R), and 4,125 euro (N). At 6 months of life the following percentages of cases are detected: U 72%, R 43%, N 13%.
  
  
  CONCLUSIONS
  A remarkable small number of economic publications mainly of low methodological quality was found. In our own model we found reasonable cost-effectiveness ratios also for universal screening. Considering the outcome advantages of higher numbers of detected cases a universal newborn hearing screening is recommended.
authors.affiliation: Institute for Health Care Management, University of Duisburg-Essen, Germany. franz.hessel@uni-essen.de
authors.forename: Franz
authors.initials: F
authors.lastname: Hessel
authors.forename: Eva
authors.initials: E
authors.lastname: Grill
authors.forename: Petra
authors.initials: P
authors.lastname: Schnell-Inderst
authors.forename: Uwe
authors.initials: U
authors.lastname: Siebert
authors.forename: Silke
authors.initials: S
authors.lastname: Kunze
authors.forename: Andreas
authors.initials: A
authors.lastname: Nickisch
authors.forename: Hubertus
authors.initials: H
authors.lastname: von Voss
authors.forename: Jürgen
authors.initials: J
authors.lastname: Wasem
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