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改进后的公共资助新生儿听力筛查项目的影响

Impact of the Improved Publicly-funded Newborn Hearing Screening Program.

作者信息

Doi Nao, Fukunaga Ichiro, Kobayashi Taisuke, Hirose Kahori, Hyodo Masamitsu, Teshima Masanori

机构信息

Department of Rehabilitation, Kochi Medical School Hospital, Kochi, Japan.

Department of Otolaryngology, Kochi Medical School, Kochi, Japan.

出版信息

JMA J. 2025 Apr 28;8(2):533-539. doi: 10.31662/jmaj.2024-0344. Epub 2025 Mar 28.

Abstract

INTRODUCTION

To increase the coverage rate and effectiveness, universal newborn hearing screening (NHS) should be financed by public funding rather than individuals. This study investigated the impact of the publicly-funded NHS program on the detection rate and the time to diagnosis and initiation of intervention for children with congenital hearing loss.

METHODS

We compared two groups: one group included newborns born between April 2011 and March 2016 who either did not pass NHS or were referred due to high risk (Group 1); the other group included newborns born between April 2017 and March 2022 who met the same criteria (Group 2). The screening costs of Group 1 were covered by the guardians' payments, whereas those of Group 2 were covered by public funding. The NHS program in Group 2 exhibited improved screening methods, course, and timing of diagnostic hearing tests for referred newborns. The number of detected newborns with hearing impairment, the period between birth and the initial visit to a diagnostic institution, and the time to intervention were evaluated.

RESULTS

Group 2 had more newborns with hearing loss (n = 51) than Group 1 (n = 32), representing a significant difference (p = 0.005). Group 2 had more children with bilateral hearing loss (n = 29) than Group 1 (n = 21), but the difference was not significant. The duration until the diagnostic test was significantly reduced in Group 2 (58 days in Group 1 vs. 35 days in Group 2). The duration of intervention also was significantly reduced in Group 2 (147 days vs. 99 days).

CONCLUSIONS

The improved program based on public funding achieved an increased number of detected infants with hearing loss. Additionally, it shortened the durations until the first diagnostic test to an institution and intervention. The new NHS program funded by local governments achieved improved effectiveness by unifying the screening method, the course of diagnostic hearing examination, and the follow-up.

摘要

引言

为提高覆盖率和有效性,新生儿听力普遍筛查(NHS)应由公共资金而非个人出资。本研究调查了公共资助的NHS项目对先天性听力损失儿童的检出率以及诊断和干预启动时间的影响。

方法

我们比较了两组:一组包括2011年4月至2016年3月出生且未通过NHS筛查或因高危因素被转诊的新生儿(第1组);另一组包括2017年4月至2022年3月出生且符合相同标准的新生儿(第2组)。第1组的筛查费用由监护人支付,而第2组的筛查费用由公共资金支付。第2组的NHS项目在转诊新生儿的筛查方法、诊断性听力测试流程和时间安排方面有所改进。评估了听力受损新生儿的检出数量、出生至首次就诊于诊断机构的时间间隔以及干预时间。

结果

第2组听力损失新生儿(n = 51)比第1组(n = 32)多,差异有统计学意义(p = 0.005)。第2组双侧听力损失儿童(n = 29)比第1组(n = 21)多,但差异无统计学意义。第2组直到诊断测试的时间显著缩短(第1组为58天,第2组为35天)。第2组的干预时间也显著缩短(147天对99天)。

结论

基于公共资金的改进项目使听力损失婴儿的检出数量增加。此外,它缩短了首次到机构进行诊断测试和干预的时间。由地方政府资助的新NHS项目通过统一筛查方法、诊断性听力检查流程和随访提高了有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6801/12095136/dd47098cf179/2433-3298-8-2-0533-g001.jpg

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