Bubbico L, Bartolucci M A, Broglio D, Boner A
Department of Biomedical Sciences, Italian Institute of Social Medicine, Rome, Italy.
Ann Ig. 2007 Mar-Apr;19(2):143-52.
Congenital hearing loss still remain an important medical and social problem for the delayed language development. Object of this study is to provide an updated and close estimate of the economic burden involved in pre-lingual hearing loss. Data were provided by the Ministry of Health data bank, the Ministry of Education national data bank, the National Institute of Social Insurance national data bank and the Italian Central Statistics Institute. The information was collected by means of a specially provided Societal Cost Questionnaire (SCQ). Direct medical costs, direct non-medical costs and indirect welfare costs involved in deafness were included in the cost estimate. Was enrolled in the study a sample of subjects with pre-lingual deafness, with a mean bilateral neuro-sensorial hearing impairment equal to 60 dB or more for 500, 1,000 and 2,000 Hz frequency tones in the better ear detected in neonatal age, had prevented speech from developing. The statistical assessment was performed according to an actuarial approach, considering the estimated life expectancy at birth, based on updated population data from census 2001. Based on life expectancy, the lifetime mean cost assessed for a subject affected by profound pre-lingual deafness turned out to be equal to Euro 737,994.76 for a male and Euro 755,404.02 for a female. Unlike other disabling affections, deafness weighs significantly more on the social system than on the health system. As a matter of fact, the direct medical costs, such as audiological diagnosis, hearing aids, etc., only account for 3.8% of the societal cost, whereas education, rehabilitation and welfare costs reach 96.2% of the total. Finally, our results suggest that societal costs can only be reduced by zeroing in on promotion and broadening of effective prevention strategies. The appropriate public health measures (such as the universal newborn hearing screening) set up and implemented in several European and non-European countries proved effective and reduced the handicap degree resulting from deafness. The investment in prevention will be widely paid.
先天性听力损失仍然是一个因语言发育迟缓而产生的重要医学和社会问题。本研究的目的是对语前听力损失所涉及的经济负担提供一个最新且精确的估计。数据由卫生部数据库、教育部国家数据库、国家社会保险研究所国家数据库以及意大利中央统计局提供。信息通过专门提供的社会成本问卷（SCQ）收集。耳聋所涉及的直接医疗成本、直接非医疗成本和间接福利成本都包含在成本估计中。本研究纳入了一组语前聋受试者样本，这些受试者在新生儿期检测出较好耳在500、1000和2000赫兹频率音的平均双侧神经感觉性听力损失等于或超过60分贝，已导致言语发育受阻。统计评估是根据精算方法进行的，考虑到基于2001年人口普查更新后的人口数据得出的出生时预期寿命。基于预期寿命，一名受严重语前聋影响的受试者的终生平均成本，男性为737,994.76欧元，女性为755,404.02欧元。与其他致残性疾病不同，耳聋对社会系统的影响远大于对卫生系统的影响。事实上，诸如听力诊断、助听器等直接医疗成本仅占社会成本的3.8%，而教育、康复和福利成本则占总数的96.2%。最后，我们的结果表明，只有专注于推广和扩大有效的预防策略，社会成本才能降低。在一些欧洲和非欧洲国家建立并实施的适当公共卫生措施（如普遍的新生儿听力筛查）已证明是有效的，并降低了耳聋导致的残疾程度。对预防的投资将得到广泛回报。
