Abstract
BackgroundThe burden of disease of hearing disorders among children is high, but a large part goes undetected. School-based screening programs in combination with the delivery of hearing aids can alleviate this situation, but the costs of such programs are unknown.AimTo evaluate the costs of a school-based screening program for hearing disorders, among approximately 216,000 school children, and the delivery of hearing aids to 206 children at three different care levels in China.MethodsIn a prospective study design, screening and hearing aid delivery costs were estimated on the basis of program records and an empirical assessment of health personnel time input. Household costs for seeking and undergoing hearing health care were collected with a questionnaire, administered to the parents of the child. Data were collected at three study sites representing primary, secondary and tertiary care levels.ResultsTotal screening and hearing aid delivery costs ranged between RMB70,000 (US$9,000) and RMB133,000 (US$17,000) in the three study sites. Health care cost per child fitted ranged from RMB5,900 (US$760) at the primary care level, RMB7,200 (US$940) at the secondary care level, to RMB8,600 (US$1,120) at the tertiary care level. Household costs were only a small fraction of the overall costs. Cost per child fitted ranged between RMB1,608 and RMB2,812 (US$209–US$365), depending on perspective of analysis and study site. The program was always least costly in the primary care setting.ConclusionHearing screening and the delivery of hearing aids in China is least costly in a primary care setting. Important questions remain concerning its implementation.
Highlights
The burden of disease of hearing disorders among children is high, but a large part goes undetected
No study has systematically evaluated the total costs and the cost per child fitted with hearing aids of such programs
There is an urgent need for research to answer these questions [3]. In response to these observations, this paper reports on the costs of a school-based screening program targeting 216,000 children of age 5–14 years, and the provision of hearing aids to 206 children at three different service levels, in China
Summary
The burden of disease of hearing disorders among children is high, but a large part goes undetected. The burden of hearing loss among children is large. The provision of hearing aids has been proposed as an effective approach, but a large proportion of all children with hearing disorders go undetected, and as a result relatively few children are fitted with hearing aids [3]. WHO estimates that only onetenth of the global population in need of hearing aids receives them [3]. Active screening for hearing disorders among children has been suggested as an effective strategy to increase case detection, and a number of studies in a range of countries have shown its feasibility in combination with provision of hearing aids [3]. There is an urgent need for research to answer these questions [3]
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