青少年时期永久性儿童听力损失的社会成本：一项关于普遍新生儿听力筛查的横断面队列随访研究
Societal costs of permanent childhood hearing loss at teen age: a cross-sectional cohort follow-up study of universal newborn hearing screening.
作者信息
Chorozoglou Maria, Mahon Merle, Pimperton Hannah, Worsfold Sarah, Kennedy Colin R
机构信息
Faculty of Medicine, University of Southampton, Southampton, UK.
Language and Cognition Research Department, University College London, London, UK.
出版信息
BMJ Paediatr Open. 2018 Feb 24;2(1):e000228. doi: 10.1136/bmjpo-2017-000228. eCollection 2018.
OBJECTIVE
To investigate the effects in adolescence of bilateral permanent childhood hearing loss (PCHL) > 40 dB and of exposure to universal newborn hearing screening (UNHS) on societal costs accrued over the preceding 12 months.
DESIGN SETTING PARTICIPANTS
An observational cohort study of a sample of 110 adolescents aged 13-20 years, 73 with PCHL and 37 in a normally hearing comparison group (HCG) closely similar in respect of place and date of birth to those with PCHL, drawn from a 1992-1997 cohort of 157 000 births in Southern England, half of whom had been exposed to a UNHS programme.
INTERVENTION
Birth in periods with and without UNHS.
OUTCOME MEASURES
Resource use and costs in the preceding 12-month period, estimated from interview at a mean age of 16.9 years and review of medical records. Effects on costs were examined in regression models.
RESULTS
Mean total costs for participants with PCHL and the HCG were £15 914 and £5883, respectively (difference £10 031, 95% CI £6460 to £13 603), primarily driven by a difference in educational costs. Compared with the HCG, additional mean costs associated with PCHL of moderate, severe and profound severity were £5916, £6605 and £18 437, respectively. The presence of PCHL and an additional medical condition (AMC) increased costs by £15 385 (95% CI £8532 to £22 238). An increase of one unit in receptive language z-score was associated with £1616 (95% CI £842 to £2389) lower costs. Birth during periods of UNHS was not associated with significantly lower overall costs (difference £3594, 95% CI -£2918 to £10 106).
CONCLUSIONS
The societal cost of PCHL was greater with more severe losses and in the presence of AMC and was lower in children with superior language scores. There was no statistically significant reduction in costs associated with birth in periods with UNHS.
TRIAL REGISTRATION NUMBER
ISRCTN03307358, pre-results.
目的
研究双侧永久性儿童听力损失（PCHL）>40dB的青少年以及接受新生儿听力普遍筛查（UNHS）对前12个月产生的社会成本的影响。
设计、地点、参与者：一项观察性队列研究，样本为110名13 - 20岁的青少年，其中73名患有PCHL，37名作为听力正常的对照组（HCG），在出生地点和日期方面与患有PCHL的青少年非常相似，样本来自1992 - 1997年英格兰南部157000例出生队列，其中一半曾接受UNHS项目。
干预措施
在有和没有UNHS的时期出生。
观察指标
前12个月的资源使用和成本，通过在平均年龄16.9岁时进行访谈并查阅病历进行估算。在回归模型中检验对成本的影响。
结果
患有PCHL的参与者和HCG的平均总成本分别为15914英镑和5883英镑（差值10031英镑，95%CI为6460英镑至13603英镑），主要是由教育成本差异导致。与HCG相比，中度、重度和极重度PCHL相关的额外平均成本分别为5916英镑、6605英镑和18437英镑。PCHL与额外的医疗状况（AMC）会使成本增加15385英镑（95%CI为8532英镑至22238英镑）。接受性语言z分数每增加一个单位，成本会降低1616英镑（95%CI为842英镑至2389英镑）。在UNHS时期出生与总体成本显著降低无关（差值3594英镑，95%CI为 - 2918英镑至10106英镑）。
结论
PCHL的社会成本在听力损失越严重以及存在AMC的情况下更高，而在语言分数较高的儿童中较低。在有UNHS的时期出生与成本降低无统计学显著关联。
试验注册号
ISRCTN03307358，预结果。
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