title: Long-term cost-effectiveness of screening strategies for hearing loss.
abstract: Routine hearing screening can identify patients who are motivated to seek out and adhere to treatment, but little information exists on the cost-effectiveness of hearing screening in a general population of older veterans. We compared the cost-effectiveness of three screening strategies (tone-emitting otoscope, hearing handicap questionnaire, and both together) against no screening (control group) in 2,251 older veterans. The effectiveness measure for each group was the proportion of hearing aid use 1 year after screening. The audiology cost measure included costs of hearing loss screening and audiology care for 1 year after screening. Incremental cost-effectiveness was the audiology cost of additional hearing aid use for each screening group compared with the control group. The mean total audiology cost per patient was $77.04, $122.70, $121.37, and $157.08 for the control, otoscope, questionnaire, and dual screening groups, respectively. The tone-emitting otoscope appears to be the most cost-effective approach for hearing loss screening, with a significant increase in hearing aid use 1 year after screening (2.8%) and an insignificant incremental cost-effectiveness of $1,439.00 per additional hearing aid user compared with the control group. For this population of older veterans, screening for hearing loss with the tone-emitting otoscope is cost-effective.
authors.affiliation: Center of Excellence for Health Services Research and Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA 98101, USA. fliu@u.washington.edu
authors.forename: Chuan-Fen
authors.initials: CF
authors.lastname: Liu
authors.forename: Margaret P
authors.initials: MP
authors.lastname: Collins
authors.forename: Pamela E
authors.initials: PE
authors.lastname: Souza
authors.forename: Bevan
authors.initials: B
authors.lastname: Yueh
mesh_terms: D000368:Aged; D001298:Audiology / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D006310:Hearing Aids / Q000191:economics / Q000706:statistics & numerical data; D034381:Hearing Loss / Q000175:diagnosis*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000379:methods*; D008875:Middle Aged; D038781:Otoscopy / Q000191:economics; D011795:Surveys and Questionnaires / Q000191:economics; D013997:Time Factors; D014728:Veterans