The Cost Effectiveness of Newborn Hearing Screening Program: New Approach of Iran Ministry of Health and Medical Education in 2022

IF 0.4 4区医学 Q4 PEDIATRICS Iranian Journal of Pediatrics Pub Date : 2024-03-18 DOI:10.5812/ijp-139634

Ehsan Moradi-Joo, Mohsen Barouni, Saeid Mahmoudian, Lila Vali

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Abstract

Background: In Iran’s newborn hearing screening (NHS) program, OAE and AABR are administered to early identify hearing impairment in the primary health care (PHC) system. Objectives: The aim of this study was to conduct a cost-effectiveness analysis of this program integrated into Iran's health system. Methods: We examined the cost-effectiveness of AABR and OAE screening procedures in infants less than 1 month old. TreeAge 2022 software was used for cost-effective modeling. In this study, QoL and QALY were considered as the outcome measures. To evaluate the robustness of the modeling results, we used one-way sensitivity analysis. A ± 20% variation was utilized to determine target variables and estimate the costs per identification. Results: In 2022, a total of 1,106,072 babies were born in Iran, of whom 1,006,293 underwent hearing impairment screening (coverage rate: 90.97%). Overall, 3,359 of the newborns screened were diagnosed with hearing problems, indicating a mean prevalence of 3.3 per 1000 births. The ICER was equal to 3297.2 US PPP (Purchasing Power Parity) per QALY. According to our results, the dominant cost-effective strategy for hearing impairment screening was OAE plus AABR. After 1000 iterations, the second cost-effective strategy was found to be OAE alone, according to Monte Carlo simulation modeling. Conclusions: In this study, we evaluated the cost-effectiveness of the NHS program for detecting hearing impairment in over a million births in Iran. A two-step screening approach, including OAE and AABR, was found to be the dominant cost-effective strategy to identify newborns with hearing impairment.

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新生儿听力筛查计划的成本效益：伊朗卫生和医学教育部 2022 年的新方法

背景：在伊朗的新生儿听力筛查（NHS）计划中，OAE 和 AABR 是为了在初级卫生保健（PHC）系统中早期识别听力障碍而实施的。研究目的本研究旨在对这项纳入伊朗医疗系统的计划进行成本效益分析。方法：我们研究了听力障碍筛查项目的成本效益：我们研究了 1 个月以下婴儿 AABR 和 OAE 筛查程序的成本效益。使用 TreeAge 2022 软件进行成本效益建模。本研究将 QoL 和 QALY 作为衡量结果。为评估建模结果的稳健性，我们使用了单向敏感性分析。利用 ± 20% 的变化来确定目标变量，并估算每次鉴定的成本。结果2022 年，伊朗共有 1,106,072 名婴儿出生，其中 1,006,293 人接受了听力障碍筛查（覆盖率：90.97%）。总体而言，3359 名接受筛查的新生儿被确诊有听力问题，表明每 1000 名新生儿的平均患病率为 3.3。每 QALY 的 ICER 为 3297.2 美元 PPP（购买力平价）。根据我们的结果，听力损伤筛查的主要成本效益策略是 OAE 加 AABR。根据蒙特卡罗模拟建模，经过 1000 次迭代后，发现成本效益第二高的策略是单纯 OAE。结论：在这项研究中，我们评估了在伊朗超过 100 万新生儿中检测听力障碍的 NHS 计划的成本效益。结果发现，包括 OAE 和 AABR 在内的两步筛查法是发现新生儿听力障碍的主要成本效益策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Iranian Journal of Pediatrics 医学-小儿科

CiteScore

0.90

自引率

20.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Iranian Journal of Pediatrics (Iran J Pediatr) is a peer-reviewed medical publication. The purpose of Iran J Pediatr is to increase knowledge, stimulate research in all fields of Pediatrics, and promote better management of pediatric patients. To achieve the goals, the journal publishes basic, biomedical, and clinical investigations on prevalent diseases relevant to pediatrics. The acceptance criteria for all papers are the quality and originality of the research and their significance to our readership. Except where otherwise stated, manuscripts are peer-reviewed by minimum three anonymous reviewers. The Editorial Board reserves the right to refuse any material for publication and advises that authors should retain copies of submitted manuscripts and correspondence as the material cannot be returned. Final acceptance or rejection rests with the Editors.