Vos Bénédicte, Senterre Christelle, Boutsen Michel, Lagasse Raphaël, Levêque Alain
Research Center Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles (ULB), Route de Lennik 808, 1070, Brussels, Belgium.
Research Center Health Policy and Systems-International Health, School of Public Health, Université libre de Bruxelles (ULB), Route de Lennik 808, 1070, Brussels, Belgium.
BMC Health Serv Res. 2018 Jan 30;18(1):56. doi: 10.1186/s12913-018-2878-3.
Newborn hearing screening programs aim to lower the ages at audiological intervention among hearing-impaired children. In Wallonia and Brussels (Belgium), audiological intervention data are not collected in the screening program, and the ages at initiating audiological care have never been assessed. This study aimed to assess the evolution in the ages at initiating audiological intervention in the context of a newborn hearing screening program implementation.
This population-based descriptive study used data from the Belgian healthcare billing database. The main outcomes were the children's ages at the initial audiological assessment, hearing-aid fitting, and cochlear implantation. Results were compared to the same outcomes from another Belgian regional program (Flanders) that was implemented one decade earlier. Annual birth cohorts from 2006 to 2011 were included in the study.
In Wallonia-Brussels, the median ages for all outcomes tended to decrease over time but remained higher than in Flanders for each birth cohort. For all outcomes except the hearing-aid fitting, differences in median ages between the two regions became less pronounced during the study period. In 2006, < 23% of the children from Wallonia-Brussels received any audiological care before the age of 12 months and these proportions were approximately 2-fold greater in the subsequent birth cohorts. For all outcomes, early care (< 12 months) was typically delivered less frequently in Wallonia-Brussels, compared to the delivery in Flanders. These region-specific differences exhibited a decreasing trend over time, and statistically significant differences were less common in the later birth cohorts.
We conclude that the hearing screening program in Wallonia and Brussels promoted earlier audiological intervention among hearing-impaired children. However, milestones recommended by experts for an early intervention were not totally encountered. We also recommend collecting audiological intervention data as part of this program, which can facilitate more accurate and regular program evaluation.
新生儿听力筛查项目旨在降低听力受损儿童接受听力学干预的年龄。在比利时的瓦隆地区和布鲁塞尔，筛查项目中未收集听力学干预数据，且且且且从未评估过开始接受听力学护理的年龄。本研究旨在评估在实施新生儿听力筛查项目的背景下，开始接受听力学干预的年龄变化情况。
这项基于人群的描述性研究使用了比利时医疗保健计费数据库中的数据。主要结果是儿童首次进行听力学评估、佩戴助听器和接受人工耳蜗植入的年龄。将结果与十年前实施的另一个比利时地区项目（弗拉芒）的相同结果进行比较。研究纳入了2006年至2011年的年度出生队列。
在瓦隆-布鲁塞尔，所有结果的中位年龄随时间推移呈下降趋势，但每个出生队列的中位年龄仍高于弗拉芒地区。除佩戴助听器外，在研究期间，两个地区的中位年龄差异变得不那么明显。2006年，来自瓦隆-布鲁塞尔的儿童中，不到23%在12个月前接受了任何听力学护理，而在随后的出生队列中，这一比例约为之前的两倍。对于所有结果，与弗拉芒地区相比，瓦隆-布鲁塞尔地区早期护理（<12个月）的提供频率通常较低。这些地区特异性差异随时间呈下降趋势，在后期出生队列中，统计学上的显著差异较少见。
我们得出结论，瓦隆地区和布鲁塞尔的听力筛查项目促进了听力受损儿童更早地接受听力学干预。然而，专家推荐的早期干预里程碑并未完全实现。我们还建议收集听力学干预数据作为该项目的一部分，这有助于更准确和定期地评估项目。
