Brockow Inken, Söhl Kristina, Hanauer Marianne, Heißenhuber Annette, Marzi Carola, Am Zehnhoff-Dinnesen Antoinette, Matulat Peter, Mansmann Ulrich, Nennstiel Uta
GP1, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Veterinärstr. 2, 85764, München-Oberschleißheim, Deutschland.
Klinik für Phoniatrie und Pädaudiologie, Westfälische Wilhelms-Universität Münster (UKM), Münster, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2023 Nov;66(11):1259-1267. doi: 10.1007/s00103-023-03779-0. Epub 2023 Oct 16.
Newborn hearing screening (NHS) was introduced nationwide by the Federal Joint Committee (Gemeinsamer Bundesausschuss, G‑BA) in 2009. In this process, quality targets were also set in the pediatrics directive. In order to review the quality NHS in Germany, the G‑BA commissioned a consortium to conduct an initial evaluation for the years 2011 and 2012 and a follow-up evaluation for 2017 and 2018.
The evaluations were based on NHS screening parameters (Sammelstatistiken) that must be documented by all obstetrics and neonatology departments as NHS providers and can also be compiled through cooperation with hearing screening centers (HSCs). Additional data were collected through questionnaires and interviews and routine data were used to evaluate the screening process.
In 13 federal states, a total of 15 HSCs are involved in the screening process. Across Germany, an NHS screening rate of 86.1% was documented in 2018 (82.4% in 2012), but this differed significantly between the federal states. The specified quality targets could not yet be implemented everywhere. For example, only less than half of the obstetric departments achieved the specified screening rate of over 95%. A comparison of data from the follow-up evaluation and the first evaluation showed that the structural quality of NHS had improved, while the process quality remained the same or had deteriorated. The refer rate (children who were discharged without passing the screening) increased from 5.3% to 6.0%.
To improve the quality of NHS, HSCs should be established nationwide and a second screening should be carried out more consistently before discharge in the case of a refer result in the initial screening.
2009年,联邦联合委员会(Gemeinsamer Bundesausschuss,G-BA)在全国范围内推行了新生儿听力筛查(NHS)。在此过程中,儿科指令中也设定了质量目标。为评估德国新生儿听力筛查的质量,G-BA委托一个财团对2011年和2012年进行初步评估,并对2017年和2018年进行后续评估。
评估基于新生儿听力筛查参数(汇总统计数据),所有产科和新生儿科作为筛查机构必须记录这些参数,也可通过与听力筛查中心(HSC)合作进行汇总。通过问卷调查和访谈收集了额外数据,并使用常规数据评估筛查过程。
在13个联邦州,共有15个听力筛查中心参与了筛查过程。在德国全国范围内,2018年记录的新生儿听力筛查率为86.1%(2012年为82.4%),但各联邦州之间存在显著差异。规定的质量目标尚未在各地实现。例如,只有不到一半的产科部门达到规定的95%以上的筛查率。后续评估与首次评估数据的比较表明,新生儿听力筛查的结构质量有所改善,而过程质量保持不变或有所恶化。转诊率(筛查未通过即出院的儿童)从5.3%上升至6.0%。
为提高新生儿听力筛查的质量,应在全国范围内建立听力筛查中心,并在初次筛查结果为转诊的情况下,更一致地在出院前进行二次筛查。