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Abstract
Objective To investigate the effects in adolescence of bilateral permanent childhood hearing loss (PCHL) > 40 dB and of exposure to universal newborn hearing screening (UNHS) on societal costs accrued over the preceding 12 months.
Design, setting, participants An observational cohort study of a sample of 110 adolescents aged 13–20 years, 73 with PCHL and 37 in a normally hearing comparison group (HCG) closely similar in respect of place and date of birth to those with PCHL, drawn from a 1992–1997 cohort of 157 000 births in Southern England, half of whom had been exposed to a UNHS programme.
Intervention Birth in periods with and without UNHS.
Outcome measures Resource use and costs in the preceding 12-month period, estimated from interview at a mean age of 16.9 years and review of medical records. Effects on costs were examined in regression models.
Results Mean total costs for participants with PCHL and the HCG were £15 914 and £5883, respectively (difference £10 031, 95% CI £6460 to £13 603), primarily driven by a difference in educational costs. Compared with the HCG, additional mean costs associated with PCHL of moderate, severe and profound severity were £5916, £6605 and £18 437, respectively. The presence of PCHL and an additional medical condition (AMC) increased costs by £15 385 (95% CI £8532 to £22 238). An increase of one unit in receptive language z-score was associated with £1616 (95% CI £842 to £2389) lower costs. Birth during periods of UNHS was not associated with significantly lower overall costs (difference £3594, 95% CI −£2918 to £10 106).
Conclusions The societal cost of PCHL was greater with more severe losses and in the presence of AMC and was lower in children with superior language scores. There was no statistically significant reduction in costs associated with birth in periods with UNHS.
Trial registration number ISRCTN03307358, pre-results.
- health economics
- audiology
- deafness
- outcomes research
- screening
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Footnotes
Contributors MC drafted the manuscript, conducted the economic analysis and approved the final manuscript. HP oversaw the conduct and analysis of the study. MM and SW assisted in the design and supervision of the study, assisted with manuscript preparation and approved the final manuscript. CRK designed and supervised the study, assisted in manuscript preparation and approved the final manuscript. MC and CRK had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Funding This work was funded by The Wellcome Trust (grant number: 089251/Z/09/Z).
Competing interests None declared.
Patient consent Parental/guardian consent obtained.
Ethics approval Southampton and South West Hampshire Research Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Unpublished data from the study are available upon reasonable request to the corresponding author.