title: [Cost-effectiveness of three-stage newborns hearing screening in Beijing].
abstract: OBJECTIVE
  To evaluate the cost-effectiveness of two-stage and three-stage hearing screenings for newborns.
  
  
  METHODS
  Hearing screening was performed for the normal newborns born in 7 hospitals in Beijing from October 2010 to December 2012 by using two stage and three stage strategies as well as hearing diagnostic test, and the cost effectiveness evaluation of two strategies was conducted. The data about the cost of screening and diagnostic test were from the hospitals. The data about car fare and charge for loss of working time of parents were collected through questionnaire survey. The sensitivity was analyzed according to the compliance rate.
  
  
  RESULTS
  A total of 62,695 newborns received initial hearing screening, 5,809 newborns failed, the positive rate was 9.30%. A total of 4,933 newborns received rescreening, 972 newborns failed, the positive rate was 19.70%. Among the newborns failed in rescreening, 412 were provided with hearing diagnostic test and 360 received diagnostic test. The diagnostic test indicated that the hearing of 217 newborns were abnormal (60.28%). A total of 276 newborns received the third screening, 163 newborns failed, in which 125 received diagnostic test and 112 had abnormal hearing (45 had moderate and above hearing impairment), the abnormal rate was 89.60%. The average cost for three-stage screening (37,242 yuan RMB per case) was higher than that for two-stage screening (19,985 yuan RMB per case). With the increase of compliance, the cost-effectiveness of three-stage screening increased.
  
  
  CONCLUSIONS
  The cost-effectiveness of three-stage screening was influenced by screening compliance. It is recommended that three-stage screening strategy might be taken in area where the screening compliance rate is >90%.
authors.affiliation: School of Health Management and Education, Capital Medical University, Beijing 100069, China.
authors.forename: Youli
authors.initials: Y
authors.lastname: Han
authors.affiliation: Beijing Institute of Otorhinolaryngology, Beijing Tongren Hospital, Capital Medical University.
authors.forename: Lihui
authors.initials: L
authors.lastname: Huang
authors.affiliation: Department of Neonate, Beijing Obstetrics Gynecology Hospital, Capital Medical University; Email: zw296@sina.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Beijing Institute of Otorhinolaryngology, Beijing Tongren Hospital, Capital Medical University.
authors.forename: Yanmei
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Neonate, Beijing Obstetrics Gynecology Hospital, Capital Medical University.
authors.forename: Xiao
authors.initials: X
authors.lastname: Jia
authors.affiliation: Beijing Institute of Otorhinolaryngology, Beijing Tongren Hospital, Capital Medical University.
authors.forename: Tingting
authors.initials: T
authors.lastname: Ni
authors.affiliation: Department of Neonate, Beijing Obstetrics Gynecology Hospital, Capital Medical University.
authors.forename: Huihong
authors.initials: H
authors.lastname: Sun
authors.affiliation: Beijing Daxing Hospital of Maternal and Child Care.
authors.forename: Ping
authors.initials: P
authors.lastname: Liang
authors.affiliation: Beijing Fengtai Hospital.
authors.forename: Huan
authors.initials: H
authors.lastname: Yu
authors.affiliation: Beijing Hospital of Chinese Traditional and Western Medicine.
authors.forename: Yan
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Beijing Fengtai Hospital of Maternal and Child Care.
authors.forename: Ai
authors.initials: A
authors.lastname: Zhang
authors.affiliation: Beijing Shunyi Hospital of Traditional Chinese Medicine.
authors.forename: Jiahui
authors.initials: J
authors.lastname: Li
authors.affiliation: Beijing Shunyi Hospital of Maternal and Child Care.
authors.forename: Hua
authors.initials: H
authors.lastname: Zhang
mesh_terms: D003362:Cost-Benefit Analysis; D034381:Hearing Loss / Q000175:diagnosis; D006320:Hearing Tests / Q000191:economics* / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D015997:Neonatal Screening / Q000191:economics* / Q000379:methods