韩国 4 个月龄全国婴幼儿健康检查中新生儿听力筛查状况：一项全国范围内基于人群的研究。
Status of the Newborn Hearing Screening in the 4-Months Age National Infant Health Checkup in Korea: A Nationwide Population-Based Study.
机构信息
Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Kangnam Sacred-Heart Hospital, Seoul, Korea.
Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea.
出版信息
J Korean Med Sci. 2023 Jan 30;38(4):e29. doi: 10.3346/jkms.2023.38.e29.
BACKGROUND
The aims of this study are to review data on 4-months age National Health Screening Program for Infants and Children (NHSPIC) using a National Health Insurance Service (NHIS) database, and to analyze the newborn hearing screening (NHS) results and related characteristics of the 4-months NHSPIC for 7 years in South Korea.
METHODS
We analyzed a NHIS database of infants who had participated in the 4-month age NHSPIC from 2010 to 2016. According to the results of hearing questionnaires and physical examination, we analyzed the outcomes of NHS and related infantile and socioeconomic factors.
RESULTS
Among 3,128,924 of total eligible infants in Korea between the year 2010 and 2016, 69.2% (2,164,621 infants) conducted 4-months age NHSPIC, and 94.4% (2,042,577 infants) of which performed hearing questionnaires regarding NHS. Among the total hearing examinees, premature infants accounted for 3.6%, infants who were hospitalized in the neonatal intensive care unit (NICU) for more than 5 days accounted for 5.6%, and infants with head and neck abnormalities were 0.6%. The NHS performing rate was 79.1% for total hearing examinees in 2010, but gradually increased to 88.9% in 2016. The NHS performing rate in 2016 was 93.4% for premature infants, 91.7% for NICU hospitalized babies. The mean referral rate was 0.6% for total hearing examinees, 1.4% for premature infants, and 2.3% for NICU hospitalized babies. When we analyzed the NHS performing rate and the referral rate according to the household income level, the NHS performing rate of infants in Medical Aid programs was the lowest as 65.6%, and the NHS performing rates in other five levels of NHIS was higher ranging between 85.1% to 86.0%. The referral rate of infants in the Medical Aid program (3.8%) was significantly higher than those of infants in other classes (1.10-1.25%).
CONCLUSION
The estimated overall NHS performing rate in Korea gradually increased and was 88.9% in 2016. The overall referral rate was low as 0.6%, and it was significantly different depending on the infant's health condition and household income levels. We assume that our finding would help to establish policies managing hearing impaired children, and to develop the customized hearing care service programs considering the household economic levels.
背景
本研究旨在利用国民健康保险服务（NHIS）数据库，回顾婴儿和儿童国家健康筛查计划（NHSPIC）4 个月龄的数据，并分析韩国 7 年来 4 个月龄 NHSPIC 的新生儿听力筛查（NHS）结果及相关特征。
方法
我们分析了 2010 年至 2016 年期间参加 4 个月龄 NHSPIC 的婴儿的 NHIS 数据库。根据听力问卷和体格检查的结果，我们分析了 NHS 的结果以及相关的婴儿和社会经济因素。
结果
在 2010 年至 2016 年期间韩国的 3128924 名合格婴儿中，69.2%（2164621 名婴儿）进行了 4 个月龄 NHSPIC，其中 94.4%（2042577 名婴儿）进行了 NHS 听力问卷。在所有接受听力检查的婴儿中，早产儿占 3.6%，在新生儿重症监护病房（NICU）住院超过 5 天的婴儿占 5.6%，头颈部异常的婴儿占 0.6%。2010 年，所有听力检查者的 NHS 执行率为 79.1%，但逐渐上升至 2016 年的 88.9%。2016 年，早产儿 NHS 执行率为 93.4%，NICU 住院婴儿为 91.7%。总听力检查者的平均转诊率为 0.6%，早产儿为 1.4%，NICU 住院婴儿为 2.3%。当我们根据家庭收入水平分析 NHS 执行率和转诊率时，医疗援助计划中婴儿的 NHS 执行率最低，为 65.6%，而 NHIS 其他五个级别的 NHS 执行率较高，在 85.1%至 86.0%之间。医疗援助计划中婴儿的转诊率（3.8%）明显高于其他类别（1.10-1.25%）的婴儿。
结论
韩国 NHS 执行率估计总体呈上升趋势，2016 年达到 88.9%。总体转诊率较低，为 0.6%，且因婴儿健康状况和家庭收入水平而异。我们假设，我们的发现将有助于制定管理听力障碍儿童的政策，并根据家庭经济水平制定定制化的听力保健服务计划。
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