Schroeder Liz, Petrou Stavros, Kennedy Colin, McCann Donna, Law Catherine, Watkin Peter M, Worsfold Sarah, Yuen Ho Ming
National Perinatal Epidemiology Unit, Oxford, United Kingdom.
Pediatrics. 2006 Apr;117(4):1101-12. doi: 10.1542/peds.2005-1335.
The objective of this study was to estimate the economic costs of bilateral permanent childhood hearing impairment (PCHI) in the preceding year of life for children aged 7 to 9 years.
A cost analysis was conducted by using a birth cohort of children born between 1992 and 1997 in 8 districts of Southern England, of which half had been born into populations exposed to universal newborn screening (UNS). Unit costs were applied to estimates of health, social, and broader resource use made by 120 hearing-impaired children and 63 children in a normally hearing comparison group. Associations between societal costs per child and severity of hearing impairment, language ability score, exposure to UNS, and age of confirmation were analyzed, including adjustment for potential confounders in a linear regression model.
The mean societal cost in the preceding year of life at 7 to 9 years of age was 14092.5 pound sterling for children with PCHI, compared with 4206.8 pound sterling for the normally hearing children, a cost difference of 9885.7 pound sterling. After adjusting for severity and other potential confounders in a linear regression model, mean societal costs among children with PCHI were reduced by 2553 pound sterling for each unit increase in the z score for receptive language. Using similar regression models, exposure to a program of UNS was associated with a smaller cost reduction of 2213.2 pound sterling, whereas costs were similar between children whose PCHI was confirmed at <9 or >9 months. CONCLUSIONS. The study provides rigorous evidence of the annual health, social, and broader societal cost of bilateral PCHI in the preceding year of life at 7 to 9 years of age and shows that it is related to its severity and has an inverse relationship with language abilities after adjustment for severity.
本研究的目的是估算7至9岁儿童生命中前一年双侧永久性儿童听力障碍(PCHI)的经济成本。
利用1992年至1997年在英格兰南部8个地区出生的一组儿童进行成本分析,其中一半儿童出生于接受普遍新生儿筛查(UNS)的人群。将单位成本应用于120名听力受损儿童和63名听力正常对照组儿童的健康、社会和更广泛资源使用的估计。分析了每名儿童的社会成本与听力障碍严重程度、语言能力得分、UNS暴露情况以及确诊年龄之间的关联,包括在线性回归模型中对潜在混杂因素进行调整。
7至9岁儿童生命中前一年,PCHI儿童的平均社会成本为14092.5英镑,而听力正常儿童为4206.8英镑,成本差异为9885.7英镑。在对线性回归模型中的严重程度和其他潜在混杂因素进行调整后,PCHI儿童的平均社会成本在接受性语言z评分每增加一个单位时降低2553英镑。使用类似的回归模型,UNS项目暴露与较小的成本降低2213.2英镑相关,而PCHI在9个月之前或之后确诊的儿童成本相似。结论。该研究提供了7至9岁儿童生命中前一年双侧PCHI年度健康、社会和更广泛社会成本的严格证据,并表明其与严重程度相关,且在调整严重程度后与语言能力呈反比关系。