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中国上海的新生儿听力筛查和干预评估。

ASSESSMENT OF UNIVERSAL NEWBORN HEARING SCREENING AND INTERVENTION IN SHANGHAI, CHINA.

机构信息

Department of Health Policy and Management,School of Public Health,Fudan University.

Health and Family Planning Commission of Hongkou.

出版信息

Int J Technol Assess Health Care. 2017 Jan;33(2):206-214. doi: 10.1017/S0266462317000344. Epub 2017 Jun 6.

Abstract

OBJECTIVES

The aim of this study was to evaluate the universal newborn hearing screening (UNHS) and intervention program in Shanghai, China.

METHODS

This study included the quantitative analyses of the UNHS-Shanghai database in 2002-12 and qualitative assessment of the program. The Otoacoustic Emissions and the Automated Auditory Brainstem Evoked Responses tests were conducted in screening. The costs and benefits were calculated based on the number of participants in each stage. The short-term and long-term periods were defined as from birth to 15 years of age or to death (82-year-olds), respectively. Sensitivity analyses were conducted.

RESULTS

A total 1,574,380 newborns were included, representing 93.6 percent of all eligible babies in Shanghai during the study period. The prevalence of newborn hearing loss was 1.66‰. The short-term/long-term program costs were ¥488.5 million (US$75.52 million)/¥1.08 billion (US$167.12 million), and the short-term/long-term program benefit was ¥980.1 million (US$151.53 million)/¥8.13 billion (US$1.26 billion). The program benefit was greater than its cost if the proportion of hearing-loss children enrolled in regular schools was no less than 41.4 percent of all hearing impaired children, as well as if the wage growth rate ranged from 3 percent to 8 percent. Qualitative results also suggested that stakeholders strongly supported this program.

CONCLUSIONS

The universal newborn hearing screening and intervention program in Shanghai is justified in terms of the resource input in the long run, although there is still room for further improvement with respect to educational rehabilitation and a better infrastructure system.

摘要

目的

本研究旨在评估中国上海的新生儿普遍听力筛查(UNHS)和干预计划。

方法

本研究包括对 2002-12 年上海 UNHS 数据库的定量分析和对该计划的定性评估。筛查采用耳声发射和自动听性脑干反应测试。根据各阶段的参与者人数计算成本和效益。短期和长期分别定义为从出生到 15 岁或死亡(82 岁)。进行了敏感性分析。

结果

共有 1574380 名新生儿被纳入研究,占研究期间上海所有符合条件婴儿的 93.6%。新生儿听力损失的患病率为 1.66‰。短期/长期计划的成本分别为 4.885 亿元人民币(7552 万美元)/10.80 亿元人民币(16712 万美元),短期/长期计划的效益分别为 9.801 亿元人民币(15153 万美元)/81.30 亿元人民币(1261.2 万美元)。如果所有听力受损儿童中有 41.4%以上进入正规学校,以及工资增长率在 3%至 8%之间,那么该计划的效益将超过其成本。定性结果还表明,利益相关者强烈支持该计划。

结论

从长远来看,上海的新生儿普遍听力筛查和干预计划在资源投入方面是合理的,尽管在教育康复和更好的基础设施系统方面仍有进一步改进的空间。

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