Stevens J C, Hall D M, Davis A, Davies C M, Dixon S
Department of Medical Physics and Clinical Engineering, Royal Hallamshire Hospital, Sheffield.
Arch Dis Child. 1998 Jan;78(1):14-9. doi: 10.1136/adc.78.1.14.
A survey was carried out in 10 centres in England and Wales to determine the costs of hearing screening in the first year of life. The screens that were studied were targeted neonatal, universal neonatal, and the health visitor distraction test (HVDT) or alternative surveillance. Valid data were available from five centres for targeted neonatal screening (TNS), three for universal neonatal screening (UNS), and nine for the HVDT, although only five of the HVDT screens had valid data for follow up costs. The neonatal costs were consistent across the centres surveyed, whereas those for the HVDT screen varied considerably. The mean service costs for TNS, UNS, and the HVDT at 1994 prices were 5052 Pounds, 13,881 Pounds, and 24,519 Pounds for a standardised district of 1000 live births. Three conclusions seem justified. Firstly, UNS need not be prohibitively expensive as it costs considerably less than HVDT screening. Secondly, TNS appears to be a relatively inexpensive way of improving the age of identification of a proportion of the congenitally hearing impaired. Thirdly, given the published yields for UNS and the HVDT, the results indicate that UNS offers the most cost effective overall approach with alternative systems in place to identify late onset permanent hearing losses.
在英格兰和威尔士的10个中心开展了一项调查，以确定一岁以内听力筛查的成本。所研究的筛查项目包括针对性新生儿筛查、普遍性新生儿筛查以及健康访视员分心测试（HVDT）或替代监测。有五个中心提供了针对性新生儿筛查（TNS）的有效数据，三个中心提供了普遍性新生儿筛查（UNS）的有效数据，九个中心提供了HVDT的有效数据，不过HVDT筛查中只有五个有后续成本的有效数据。各被调查中心的新生儿筛查成本较为一致，而HVDT筛查的成本差异很大。以1994年价格计算，对于一个有1000例活产的标准化地区，TNS、UNS和HVDT的平均服务成本分别为5052英镑、13881英镑和24519英镑。似乎可以得出三个结论。其一，普遍性新生儿筛查并非贵得让人望而却步，因为其成本远低于HVDT筛查。其二，针对性新生儿筛查似乎是提高部分先天性听力受损者确诊年龄的一种相对低成本的方式。其三，鉴于已公布的普遍性新生儿筛查和HVDT筛查的筛查率，结果表明，普遍性新生儿筛查在有替代系统来识别迟发性永久性听力损失的情况下，提供了最具成本效益的总体方法。
