title: A pre-paid newborn hearing screening programme: a community-based study.
abstract: OBJECTIVE
  To help obstetric hospitals and clinics to implement newborn hearing screening and to test the feasibility of a pre-paid model for screening.
  
  
  METHODS
  From July 2005 to August 2008, we organised a coordinated newborn hearing screening team with portable automated auditory brainstem response (AABR) to provide in-patient screening after delivery and out-patient re-screening at one month of age in birthing facilities throughout Changhua County, Taiwan. This was a community-based study organised by otolaryngologists at a tertiary referral centre.
  
  
  RESULTS
  Ten medical facilities participated in our screening programme. 7,139 out of 12,901 neonates delivered in these facilities during the period were screened for hearing loss. 105 (1.47%) babies who did not pass the in-patient screening were re-screened at one month old. Forty (0.56%) babies referred from the re-screening were sent for diagnostic work-up and six of them failed to show up. The overall follow-up rate was 94.3% (99/105). Eleven babies with bilateral hearing loss and eight babies with unilateral hearing loss were diagnosed. The incidence of bilateral hearing loss in our programme was 1.5/1000. The screening rate descended from medical centre to clinic (p < 0.0001). There was no significant difference between the referral rates for different levels of birthing facilities (p = 0.5611).
  
  
  CONCLUSIONS
  Our study demonstrates that a pre-paid model using AABR is feasible at all three levels of medical facilities. Pre-paid community-based screening might be an option for developing countries in the implementation of universal newborn hearing screening.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: J Y
authors.initials: JY
authors.lastname: Fan
authors.forename: L S
authors.initials: LS
authors.lastname: Chen
authors.forename: J C
authors.initials: JC
authors.lastname: Lai
authors.forename: M K
authors.initials: MK
authors.lastname: Chen
authors.forename: H C
authors.initials: HC
authors.lastname: Chen
mesh_terms: D003153:Community Health Services; D016057:Evoked Potentials, Auditory, Brain Stem; D005240:Feasibility Studies; D006801:Humans; D007231:Infant, Newborn; D015997:Neonatal Screening / Q000191:economics / Q000458:organization & administration*; D017084:Otoacoustic Emissions, Spontaneous; D013624:Taiwan