Otolaryngology Research Center, Department of Otorhinolaryngology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Student Research Committee, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
BMC Pediatr. 2022 May 30;22(1):318. doi: 10.1186/s12887-022-03384-1.
Hearing loss is the second most common chronic disease, the diagnosis and treatment of which can be faster through screening. In addition, early interventions will save significant costs for the education and health systems. Therefore, the present study aimed to evaluate the cost-effectiveness of hearing screening for primary school children in Shiraz.
This cross-sectional economic evaluation of cost-effectiveness was conducted from the perspective of the health system. The study population comprised all seven-year-old children participating in the screening program in Shiraz. The present study dealt only with direct costs. The expected costs and outcomes, as well as the ICER index were estimated using the decision tree model. The study outcomes included averted disability-adjusted life years (DALY) and true identification of hearing loss cases. The robustness of the results was evaluated using the one-way sensitivity analysis. The TreeAge 2020 and Excel 2016 software were also used to analyze the collected data.
The hearing screening data obtained during 6 years (2015-2020) showed that every year, an average of 22,853 children in Shiraz were examined for hearing, of which 260 were true positive (%1.1). The costs of screening and lack of screening were estimated at $30.32 Purchasing Power Parity (PPP) and $13.75 PPP per child, respectively. The averted DALY due to performing hearing screening was estimated at 7 years for each child. The ICER was positive and equal to $ 0.06 PPP for the identified cases and $ 2.37 PPP per averted DALY. The sensitivity analysis confirmed the robustness of the results.
According to the results, although hearing screening for primary school children had more costs and effectiveness, it was considered cost-effective. Therefore, universal screening with high quality and accuracy is recommended.
听力损失是第二大常见的慢性疾病，通过筛查可以更快地进行诊断和治疗。此外，早期干预将为教育和卫生系统节省大量成本。因此，本研究旨在评估对设拉子小学生进行听力筛查的成本效益。
这是一项从卫生系统角度进行的成本效益的横断面经济学评价。研究人群包括所有参加设拉子筛查计划的 7 岁儿童。本研究仅涉及直接成本。使用决策树模型估算预期成本和结果以及增量成本效益比 (ICER) 指数。研究结果包括避免残疾调整生命年 (DALY) 和真正发现听力损失病例。使用单因素敏感性分析评估结果的稳健性。还使用 TreeAge 2020 和 Excel 2016 软件分析收集的数据。
在 6 年（2015-2020 年）期间获得的听力筛查数据显示，每年设拉子平均有 22853 名儿童接受听力检查，其中 260 例为真阳性（1.1%）。筛查和不筛查的成本估计分别为每个儿童 30.32 美元（购买力平价）和 13.75 美元（购买力平价）。由于进行听力筛查，每个儿童的 DALY 避免量估计为 7 年。ICER 为阳性，对于已识别的病例为 0.06 美元（购买力平价）/人，对于避免的 DALY 为 2.37 美元（购买力平价）/人。敏感性分析证实了结果的稳健性。
根据结果，尽管对小学生进行听力筛查的成本更高，但效果更好，因此被认为是具有成本效益的。因此，建议进行高质量和高准确性的全民筛查。
