Results and Cost-Effectiveness of Newborn Hearing Screening Program in Ajou University Hospital

Abstract

BACKGROUND AND OBJECTIVES: It is estimated that more than 2 in every 1,000 neonates suffers from hearing loss. Early detection with appropriate rehabilitation of congenital hearing loss can reduce the adverse developmental consequences such as language delays, and behavior and attention deficits. The purpose of this study is to evaluate our newborn hearing screening program using the combined transient evoked otoacoustic emission (TEOAE) and auditory brainstem response (ABR), and to estimate the cost-effectiveness of our program. MATERIALS AND METHOD: 6,634 infants (5,918 well babies and 716 NICU babies) underwent the newborn hearing screening program at Ajou University Hospital for 4 years. Initially well babies were screened with TEOAEs, and those failing the TEOAEs were tested with the rescreening program. Neonates failing the TEOAE rescreening and the NICU babies were examined with ABR. The cost included personnel, fringe benefits, supplies, equipment and overhead. RESULTS: 660 (11%) out of 5,918 well babies failed the initial TEOAE screening and 27 (0.46%) babies failed the TEOAE rescreening. Eleven babies (0.16%), 3 of the well babies and 8 of the NICU babies, were confirmed to have hearing loss of more than 60 dB. We detected four deaf babies out of these eleven. From the four deaf babies, we confirmed a connexin 26-related deafness and an enlarged vestibular aqueduct syndrome. It cost $6 to screen one infant and $3,700 to detect one infant with hearing loss. CONCLUSION: We could detect 11 babies (0.16%) with hearing loss out of 6,634 neonates during the 4 years. Considering the benefits of early identification and rehabilitation of congenital hearing loss, the cost for the newborn hearing screen program is affordable. The newborn hearing screen should be extended as a national health program.