Cost-effectiveness analysis of neonatal hearing screening program in china: should universal screening be prioritized?
| Autor: | Xiao-Yan Yue, Hong-Hui Li, Yan-Qing Gu, Lin Tu, Xiao-Huan Cheng, Qing-Lin Ke, Fei Mai, Ru-Lan Yang, Lingzhong Xu, Mei Zhang, Beier Qi, Yue Teng, Sai-Nan Xu, Demin Han, Lihui Huang, Xue-Feng Zhang, Wei Tang, Ruoyan Gai Tobe, Xiao-Dong Li, Long Sun, Luo Zhang, Fang-Hua Qi |
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| Rok vydání: | 2012 |
| Předmět: |
Program evaluation
China medicine.medical_specialty Databases Factual National Health Programs Cost-Benefit Analysis Developing country Hospitals Maternity Health informatics Health Services Accessibility Health administration Neonatal Screening Nursing Cost Savings medicine Humans Hearing Loss Hearing Disorders Models Statistical business.industry lcsh:Public aspects of medicine Hearing Tests Health Policy Public health Nursing research Infant Newborn Infant lcsh:RA1-1270 Cost-effectiveness analysis Hospitals Pediatric Quality-adjusted life year Education Special Family medicine Quality of Life Quality-Adjusted Life Years business Program Evaluation Research Article |
| Zdroj: | BMC Health Services Research BMC Health Services Research, Vol 12, Iss 1, p 97 (2012) |
| ISSN: | 1472-6963 |
| DOI: | 10.1186/1472-6963-12-97 |
| Popis: | Background Neonatal hearing screening (NHS) has been routinely offered as a vital component of early childhood care in developed countries, whereas such a screening program is still at the pilot or preliminary stage as regards its nationwide implementation in developing countries. To provide significant evidence for health policy making in China, this study aims to determine the cost-effectiveness of NHS program implementation in case of eight provinces of China. Methods A cost-effectiveness model was conducted and all neonates annually born from 2007 to 2009 in eight provinces of China were simulated in this model. The model parameters were estimated from the established databases in the general hospitals or maternal and child health hospitals of these eight provinces, supplemented from the published literature. The model estimated changes in program implementation costs, disability-adjusted life years (DALYs), average cost-effectiveness ratio (ACER), and incremental cost-effectiveness ratio (ICER) for universal screening compared to targeted screening in eight provinces. Results and discussion A multivariate sensitivity analysis was performed to determine uncertainty in health effect estimates and cost-effectiveness ratios using a probabilistic modeling technique. Targeted strategy trended to be cost-effective in Guangxi, Jiangxi, Henan, Guangdong, Zhejiang, Hebei, Shandong, and Beijing from the level of 9%, 9%, 8%, 4%, 3%, 7%, 5%, and 2%, respectively; while universal strategy trended to be cost-effective in those provinces from the level of 70%, 70%, 48%, 10%, 8%, 28%, 15%, 4%, respectively. This study showed although there was a huge disparity in the implementation of the NHS program in the surveyed provinces, both universal strategy and targeted strategy showed cost-effectiveness in those relatively developed provinces, while neither of the screening strategy showed cost-effectiveness in those relatively developing provinces. This study also showed that both strategies especially universal strategy achieve a good economic effect in the long term costs. Conclusions Universal screening might be considered as the prioritized implementation goal especially in those relatively developed provinces of China as it provides the best health and economic effects, while targeted screening might be temporarily more realistic than universal screening in those relatively developing provinces of China. |
| Databáze: | OpenAIRE |
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