机构：[1]Beijing Tongren Hospital, Capital Medical University, Beijing, China首都医科大学附属北京同仁医院首都医科大学附属同仁医院[2]BeijingInstitute of Otolaryngology, Key Laboratory of Otolaryngology Head andNeck Surgery (Capital Medical University), Ministry of Education, China, 17Hou-gou Lane, Chong-nei Street, Beijing 100005, China首都医科大学附属同仁医院[3]Graduate School ofMedicine, The University of Tokyo, Tokyo, Japan[4]Tokyo University Hospital,Tokyo, Japan[5]Institute of Social Medicine and Health Services Management,School of Public Health, Shandong University, Wen-hua-xi Road No.44, JinanCity, Shandong Province 250012, China[6]Guangdong Province Maternal andChild Health Hospital, Guangzhou, Guangdong, China[7]Beijing HaidianDistrict Maternal and Child Heath Hospital, Beijing, China[8]Hebei ProvinceLangfang City Maternal and Child Health Hospital, Langfang, Hebei, China[9]Henan Province Anyang City Maternal and Child Heath Hospital, Anyang,Henan, China[10]Jiangxi Province Jiujiang City Maternal and Child HealthHospital, Jiujiang, Jiangxi, China[11]Guangxi Province Liuzhou City Maternaland Child Heath Hospital, Liuzhou, Guangxi, China[12]Beijing ShangdiHospital, Beijing, China[13]The Third People’s Hospital of Wenzhou City,Wenzhou, Zhejiang, China[14]Hebei Province Chengde City Maternal andChild Health Hospital, Chengde, Hebei, China[15]Hebei Province TangshanCity Maternal and Child Health Hospital, Tangshan, Hebei, China
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.
基金：
Guangdong Province Maternal and Child Health Hospital; Jiangxi Province Jiujiang City Maternal and Child Health Hospital; Hebei Province Langfang City Maternal and Child Health Hospital; Beijing HaiDian District Maternal and Child Heath Hospital; Third People's Hospital of Wenzhou City (Zhejiang Province); Henan Province Anyang City Maternal and Child Heath Hospital; Guangxi Province Liuzhou City Maternal and Child Heath Hospital; Beijing Shangdi Hospital; Hebei Province Chengde City Maternal and Child Health Hospital
第一作者机构：[1]Beijing Tongren Hospital, Capital Medical University, Beijing, China[2]BeijingInstitute of Otolaryngology, Key Laboratory of Otolaryngology Head andNeck Surgery (Capital Medical University), Ministry of Education, China, 17Hou-gou Lane, Chong-nei Street, Beijing 100005, China
共同第一作者：
通讯作者：
通讯机构：[1]Beijing Tongren Hospital, Capital Medical University, Beijing, China[2]BeijingInstitute of Otolaryngology, Key Laboratory of Otolaryngology Head andNeck Surgery (Capital Medical University), Ministry of Education, China, 17Hou-gou Lane, Chong-nei Street, Beijing 100005, China
推荐引用方式(GB/T 7714)：
Li-Hui Huang,Luo Zhang,Ruo-Yan Gai Tobe,et al.Cost-effectiveness analysis of neonatal hearing screening program in china: should universal screening be prioritized?[J].BMC HEALTH SERVICES RESEARCH.2012,12:doi:10.1186/1472-6963-12-97.
APA：
Li-Hui Huang,Luo Zhang,Ruo-Yan Gai Tobe,Fang-Hua Qi,Long Sun...&De-Min Han.(2012).Cost-effectiveness analysis of neonatal hearing screening program in china: should universal screening be prioritized?.BMC HEALTH SERVICES RESEARCH,12,
MLA：
Li-Hui Huang,et al."Cost-effectiveness analysis of neonatal hearing screening program in china: should universal screening be prioritized?".BMC HEALTH SERVICES RESEARCH 12.(2012)
