Abstract
BackgroundThere is great diversity in the policies for scoliosis screening worldwide. The initial enthusiasm was succeeded by skepticism and the worth of screening programs has been challenged. The criticisms of school screening programs cite mainly the negative psychological impact on children and their families and the increased financial cost of visits and follow-up radiographs. The purpose of this report is to evaluate the direct cost of performing the school screening in a district hospital.MethodsA cost analysis was performed for the estimation of the direct cost of the "Thriasio" school-screening program between January 2000 and May 2006. The analysis involved all the 6470 pupils aged 6–18 years old who were screened at schools for spinal deformities during this period. The factors which were taken into consideration in order to calculate the direct cost of the screening program were a) the number of the examiners b) the working hours, c) the examiners' salary, d) the cost of transportation and finally e) the cost of examination per child.ResultsDuring the examined period 20 examiners were involved in the program and worked for 1949 working hours. The hourly salary for the trainee doctors was 6.80 euro, for the Health Visitors 6.70 euro and for the Physiotherapists 5.50 euro in current prices. The cost of transportation was 32 euro per year. The direct cost for the examination of each child for the above studied period was calculated to be 2.04 euro.ConclusionThe cost of our school-screening program is low. The present study provides a strong evidence for the continuation of the program when looking from a financial point of view.
Highlights
There is great diversity in the policies for scoliosis screening worldwide
US Preventive Service Task Force recommends against the routine screening of asymptomatic adolescents for idiopathic scoliosis [7]
Criticism of school screening programs cite mainly the negative impact on children and their parents, because they produce anxiety, inconvenience, radiation exposure from follow-up roentgenograms, school missing for students and loss of working hours for parents for unnecessary follow up appointments [9]
Summary
There is great diversity in the policies for scoliosis screening worldwide. The initial enthusiasm was succeeded by skepticism and the worth of screening programs has been challenged. The criticisms of school screening programs cite mainly the negative psychological impact on children and their families and the increased financial cost of visits and follow-up radiographs. Scoliosis Research Society and the American Academy of Orthopaedic Surgeons continue to support the principle of school screening for scoliosis [5] and recommend screening girls at ages 11 and 13 years and screening boys (page number not for citation purposes). The British Orthopaedic Association and the British Scoliosis Society conclude that it should not be a national policy to screen children for scoliosis routinely throughout the United Kingdom [8]. Criticism of school screening programs cite mainly the negative impact on children and their parents, because they produce anxiety, inconvenience, radiation exposure from follow-up roentgenograms, school missing for students and loss of working hours for parents for unnecessary follow up appointments [9]. The financial cost of the screening programs, the cost of visits and the cost of follow-up radiographs has been implicated [10]
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