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Three Common Hearing Screening Tests Have Similar Costs.

WASHINGTON -- The total cost to screen a newborn's hearing is similar for three commonly used screening methods.

There are distinct differences in cost of transient evoked otoacoustic emissions (TEOAE), automated auditory brain stem response (AABR), and a two-step protocol of TEOAE and AABR. But a multicenter study found that differences in referral rates and personnel involved equalize the costs of the three methods, Dr. Betty Vohr said at the annual meeting of the American Academy of Pediatrics.

The study is the first one to compare total costs for the screening methods, said Dr. Vohr, professor of pediatrics at Brown University.

Retrospective data were obtained on 12,081 screened infants to calculate referral rates and prospective data were obtained on 5,280 infants to calculate resource utilization.

TEOAE had a significantly higher referral rate (6.5%) than the two-step protocol (4.7%) and AABR (3.2%). The difference between the two-step protocol and the AABR was also significant.

The higher referral rate of TEOAE is due to its lower threshold for an abnormal result if the patient has debris or fluid in the middle ear, Dr. Vohr said. In the two-step protocol, all infants receive a TEOAE screen and only those who fail the TEQAF screen go on to a AABR screen, which was approximately 20% in the study.

Predischarge costs for 1,500 births, which includes personnel, equipment, supplies, and program overhead, was lowest for TEOAE and highest for AABR (See table.)

Postdischarge costs, which include follow-up screens and diagnostic evaluations, however, were greatest for TEOAE and lowest for AABR.

After adjusting for the type of personnel at the TEOAE sites, the costs of all three protocols were similar, Dr. Vohr said.

The sites utilizing the two-step protocol and AABR used parttime personnel while the TEOAE sites only used full-time personnel.

                       Economic Analysis of Newborn
                         Hearing Screening Methods
                          TEOAE     AABR      TEOAE + AABR
Referral rate [*]         6.5%      3.2%      4.7%
Personnel                 full-time part-time full- and part-time
Predischarge costs [*]    $24,668   $38,137   $35,247
Postdischarge costs [*]   $18,373   $11,077   $14,925
Total costs [*]           $43,041   $47,215   $49,582
Cost per infant           $28.69    $32.81    $33.05
Cost per identified child $14,347   $16,405   $16,527
(*.)Based on 1,500 births.
Source: Dr. Betty Vohr
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Publication:Family Practice News
Article Type:Brief Article
Date:Dec 15, 1999
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