Economic evaluation of long-term impacts of universal newborn hearing screening.
Little is known about the long-term efficacious and economic impacts of universal newborn hearing screening (UNHS).



An analytical Markov decision model was framed with two screening strategies: UNHS with transient evoked otoacoustic emission (TEOAE) test and automatic acoustic brainstem response (aABR) test against no screening. By estimating intervention and long-term costs on treatment and productivity losses and the utility of life years determined by the status of hearing loss, we computed base-case estimates of the incremental cost-utility ratios (ICURs). The scattered plot of ICUR and acceptability curve was used to assess the economic results of aABR versus TEOAE or both versus no screening.



A hypothetical cohort of 200,000 Taiwanese newborns.



TEOAE and aABR dominated over no screening strategy (ICUR = $-4800.89 and $-4111.23, indicating less cost and more utility). Given $20,000 of willingness to pay (WTP), the probability of being cost-effective of aABR against TEOAE was up to 90%.



UNHS for hearing loss with aABR is the most economic option and supported by economically evidence-based evaluation from societal perspective.
a Institute of Public Health , National Yang-Ming University , Taipei , Taiwan.
Shu-Ti
ST
Chiou
b Department of Pediatric , Mackay Memorial Hospital , Hsin-Chu , Taiwan.|c Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health , National Taiwan University , Taipei , Taiwan.
Hou-Ling
HL
Lung
d School of Oral Hygiene, College of Oral Medicine , Taipei Medical University , Taipei , Taiwan.
Li-Sheng
LS
Chen
d School of Oral Hygiene, College of Oral Medicine , Taipei Medical University , Taipei , Taiwan.
Amy Ming-Fang
AM
Yen
e Department of Health Industry Management, School of Healthcare Management , Kainan University , Tao-Yuan , Taiwan , and.
Jean Ching-Yuan
JC
Fann
f Department of Health Care Management, College of Management , Chang Gung University , Tao-Yuan , Taiwan.
Sherry Yueh-Hsia
SY
Chiu
c Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health , National Taiwan University , Taipei , Taiwan.
Hsiu-Hsi
HH
Chen
D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D003663:Decision Trees; D016057:Evoked Potentials, Auditory, Brain Stem; D017048:Health Care Costs; D006309:Hearing; D006311:Hearing Disorders / Q000175:diagnosis* / Q000191:economics* / Q000503:physiopathology; D006320:Hearing Tests / Q000191:economics* / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D008390:Markov Chains; D018803:Models, Economic; D015997:Neonatal Screening / Q000191:economics* / Q000379:methods; D017084:Otoacoustic Emissions, Spontaneous; D011237:Predictive Value of Tests; D019057:Quality-Adjusted Life Years; D013624:Taiwan; D013997:Time Factors
Cost-effectiveness (utility) analysis; analytical Markov decision model; universal newborn hearing screening