Cost analysis of an Italian neonatal hearing screening programme

Abstract

Aim: The objective of this study was to estimate the cost of a Universal Neonatal Hearing Screening (UNHS) programme in an Italian region.

Methods: A cost analysis of a regional UNHS programme was carried out on 32,502 newborns. 31,992 (98.4%) were no audiological risk (NAR) subjects and 510 were babies with audiological risk (WAR) (1.6%). UNHS was performed on two levels. The first level involved otoacustic emission (OAE) testing on NAR subjects, while the second level involved auditory brainstem response (ABR) testing of WAR and of NAR with 2nd OAE Refer tests.

Results: The cost of screening was 13.32 euro per screened NAR infant. The total cost (OAE+ABR) was 16.58 euro, spreading the cost over the whole NAR population. The total cost per screened infant in the WAR population was 415.9 euro. The average cost per detected case in the NAR population was 32,951 euro, while in the WAR population it was 11,303 euro.

Conclusions: The cost of UNHS in our region is comparable to the cost per diagnosed case of other neonatal screening programmes, and it is justified when it allows us to intervene at an early stage. On the basis of both the cost of our regional screening programme and the incidence of hearing impairment, we can conclude that the cost-effectiveness of our programme has been demonstrated.