Costs of school scoliosis screening: a large, population-based study.
METHODS
This was a population-based retrospective study.


OBJECTIVE
To fully estimate the costs of the Hong Kong scoliosis screening program through a large, population-based study.


BACKGROUND
School screening for scoliosis has often been criticized for having high costs. In fact, the screening cost that has reported varied widely, from less than 1 to more than 30 US dollars (USD) per child screened. This variation is mainly due to the incomplete inclusion of cost items.


METHODS
We examined the screening and medical histories of a cohort of 115,190 screened students who were in Grade 5 in 1995/96 or 1996/97. The average costs spent on screening, diagnosing, following, and treating this cohort of students were calculated.


RESULTS
The total expenses in the screening centers increased steadily from USD 380,930 in 1995/96 to USD 2,417,824 in 2005/06. Based on the 115,190 students who were followed up until they were 19 years old or they left school, the costs of screening and diagnosing 1 student during adolescence were USD 17.94 and USD 2.08, respectively. Of the 1311 referrals who attended the specialist hospitals for diagnosis, 264 and 39 had been braced and operated on, respectively. The medical care cost averaged USD 34.61 per student screened. The cost of finding 1 student with a curvature ≥20° and 1 treated case were USD 4475.67 and USD 20,768.29 respectively.


CONCLUSIONS
This was the largest study that has evaluated school scoliosis screening on students who were followed during their adolescence and accounted for all relevant costs. The cost per student screened in the scoliosis screening program in Hong Kong was comparable to that in Rochester, which had a similar protocol and was evaluated in a similar manner. The estimated costs can help the policy makers when they allocate healthcare resources.
Department of Nursing Studies, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
C F
CF
Lee
Daniel Y T
DY
Fong
Kenneth M C
KM
Cheung
Jack C Y
JC
Cheng
Bobby K W
BK
Ng
T P
TP
Lam
K H
KH
Mak
Paul S F
PS
Yip
Keith D K
KD
Luk
D000293:Adolescent; D002648:Child; D017048:Health Care Costs / Q000639:trends*; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008403:Mass Screening / Q000191:economics*; D012189:Retrospective Studies; D012572:School Health Services / Q000191:economics; D012574:Schools; D012600:Scoliosis / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology; D013334:Students