title: A public health economic assessment of hospitals' cost to screen newborns for critical congenital heart disease.
abstract: OBJECTIVE
  Critical congenital heart disease (CCHD) was recently added to the U.S. Recommended Uniform Screening Panel for newborns. This evaluation aimed to estimate screening time and hospital cost per newborn screened for CCHD using pulse oximetry as part of a public health economic assessment of CCHD screening.
  
  
  METHODS
  A cost survey and time and motion study were conducted in well-newborn and special/intensive care nurseries in a random sample of seven birthing hospitals in New Jersey, where the state legislature mandated CCHD screening in 2011. The sample was stratified by hospital facility level, hospital birth census, and geographic location. At the time of the evaluation, all hospitals had conducted CCHD screening for at least four months.
  
  
  RESULTS
  Mean screening time per newborn was 9.1 (standard deviation = 3.4) minutes. Hospitals' total mean estimated cost per newborn screened was $14.19 (in 2011 U.S. dollars), consisting of $7.36 in labor costs and $6.83 in equipment and supply costs.
  
  
  CONCLUSIONS
  This federal agency-state health department collaborative assessment is the first state-level analysis of time and hospital costs for CCHD screening using pulse oximetry conducted in the U.S. Hospitals' cost per newborn screened for CCHD with pulse oximetry is comparable with cost estimates of existing newborn screening tests. Hospitals' equipment costs varied substantially based on the pulse oximetry technology employed, with lower costs among hospitals that used reusable screening sensors. In combination with estimates of screening accuracy, effectiveness, and avoided costs, information from this evaluation suggests that CCHD screening is cost-effective.
authors.affiliation: Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA ; Current affiliation: Centers for Disease Control and Prevention, National Center on Injury Prevention and Control, Atlanta, GA.
authors.forename: Cora
authors.initials: C
authors.lastname: Peterson
authors.affiliation: Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Grosse
authors.affiliation: Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA.
authors.forename: Jill
authors.initials: J
authors.lastname: Glidewell
authors.affiliation: New Jersey Department of Health, Division of Family Health Services, Special Child Health and Early Intervention Services, Trenton, NJ.
authors.forename: Lorraine F
authors.initials: LF
authors.lastname: Garg
authors.affiliation: Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA ; New Jersey Department of Health, Division of Family Health Services, Special Child Health and Early Intervention Services, Trenton, NJ.
authors.forename: Kim
authors.initials: K
authors.lastname: Van Naarden Braun
authors.affiliation: New Jersey Department of Health, Division of Family Health Services, Special Child Health and Early Intervention Services, Trenton, NJ.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Knapp
authors.affiliation: New Jersey Department of Health, Division of Family Health Services, Special Child Health and Early Intervention Services, Trenton, NJ.
authors.forename: Leslie M
authors.initials: LM
authors.lastname: Beres
authors.affiliation: Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA.
authors.forename: Cynthia F
authors.initials: CF
authors.lastname: Hinton
authors.affiliation: Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA.
authors.forename: Richard S
authors.initials: RS
authors.lastname: Olney
authors.affiliation: Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA.
authors.forename: Cynthia H
authors.initials: CH
authors.lastname: Cassell
mesh_terms: D003362:Cost-Benefit Analysis; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000191:economics; D017721:Hospital Costs; D006801:Humans; D007231:Infant, Newborn; D015997:Neonatal Screening / Q000191:economics*; D009515:New Jersey; D010092:Oximetry / Q000191:economics* / Q000295:instrumentation; D013996:Time and Motion Studies