Cost-effectiveness analysis of a national neonatal hearing screening program in China: conditions for the scale-up.
BACKGROUND
In 2009, the Chinese Ministry of Health recommended scale-up of routine neonatal hearing screening - previously performed primarily only in select urban hospitals - throughout the entire country.


METHODS
A decision analytical model for a simulated population of all live births in china was developed to compare the costs and health effects of five mutually exclusive interventions: 1) universal screening using Otoacoustic Emission (OAE) and Automated Auditory Brainstem Response (AABR); 2) universal OAE; 3) targeted OAE and AABR; 4) targeted OAE; and 5) no screening. Disability-Adjusted Life Years (DALYs) were calculated for health effects.


CONCLUSIONS
Based on the cost-effectiveness and potential health outcomes, the optimal path for scale-up would be to start with targeted OAE and then expand to universal OAE and universal OAE plus AABR. Accessibility of screening, diagnosis, and intervention services significantly affect decision of the options.


CONCLUSIONS
In conclusion, to achieve cost-effectiveness and best health outcomes of the NHS program, the accessibility of screening, diagnosis, and intervention services should be expanded to reach a larger population. The results are thus expected to be of particular benefit in terms of the 'rolling out' of the national plan.
School of Public Health, Shandong University, Jinan, Shandong Province, China.
Ruoyan Gai
RG
Tobe
Rintaro
R
Mori
Lihui
L
Huang
Lingzhong
L
Xu
Demin
D
Han
Kenji
K
Shibuya
D002681:China; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D006320:Hearing Tests / Q000191:economics* / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D015997:Neonatal Screening / Q000191:economics* / Q000379:methods*; D017063:Outcome Assessment, Health Care; D011336:Probability; D019057:Quality-Adjusted Life Years