Community-based newborn hearing screening program in Taiwan

Abstract

Objective: Congenital bilateral hearing impairment occurs in approximately 1 in every 1000 live births. Universal newborn hearing screening (UNHS) programs are the most effective method for early diagnosis. Previously, newborn hearing screenings in Taiwan were often hospital-based. Our study is a community-based program designed to test the feasibility of performing neonatal hearing screening with a pay-for-test model, and to evaluate its acceptability to parents. Methods: From March 2000 to December 2002, two hospitals and four obstetric clinics in Tainan city participated in this study. The subjects were healthy newborns whose parents agreed to pay for otoacoustic emissions (OAE) hearing screening. They were tested in the newborn nursery before discharge. The protocol used an initial transient evoked otoacoustic emissions screening followed by a diagnostic auditory brainstem response (ABR) test. Results: A total of 10,008 healthy neonates were recruited, and 5938 newborns (59.3%) were tested. Prior to hospital discharge, 5403 of the newborns (91.0%) had passed the transient evoked otoacoustic emissions test. Referral for further testing was made in 9.0% of cases (535/5938). There were 140 babies lost to 1-month follow up. Only 395 infants (73.8%) of the infants that failed their first otoacoustic emissions tests underwent a second session at the outpatient clinic, and 91 babies failed. They were referred for further auditory brainstem response testing. Ultimately, nine babies were diagnosed with sensorineural hearing loss (SNHL). Conclusions: There are difficulties in performing universal newborn hearing screening within Taiwan’s health insurance system. This study was performed with the cooperation of hospitals and obstetric clinics, and was undertaken with a pay-for-screening model. Our program, with a pay-for-test model, of newborn hearing screening is feasible and was well regarded by parents in Tainan city. It could be run without the government’s financial support.