Research On The Incidence Of Newborns Hearing Impairment And Cost-Benefit Of UNHS By DPOAE And AABR In Gansu Province

Objective:1. Using DPOAE combined with AABR implement the newborn hearing screening in Gansu province, to understand the status of neonatal congenital deafness incidence;2. Using cost-benefit ratio (BCR) evaluate the DPOAE combined with AABR procedure’s economic effect, to demonstrate an alternative method to audiologists, administrators, and others involved in UNHS protocol decisions.Methods:71467infants born in appointed Maternal and Child Health (MCH) Hospital of Gansu province during September1st,2012to August31st,2013were tested using DPOAE as well as AABR in48-72hours. were taken part in the second screening interval42days; Those newborns who still failed the second screening joined in the audiological diagnosis and follow up.Using the incidence of neonatal congenital hearing loss we have concluded, and the existing literature data combined with financial input in Gansu province health department to estimate costs and benefits to calculate BCR.Using SPSS18.0software for data analysis, the result of P<0.05showed that the data have statistically significant difference.Result:1. Out of71467infants,13647(19.10%) infants failed the first screening, and419infants failed the first and second screening. but only326of them received diagnostic assessment, of whom138(1.93%o) infants were diagnosed as hearing loss.36(0.50%o) infants with profound hearing loss,27(0.38%o) infants with severe hearing loss,44(0.62‰) cases with moderate hearing loss,31(0.43‰o) cases with mild hearing loss,40(0.56‰) cases with bilateral profound-to-severe deafness.2. There were37257boys,73(1.96‰) cases were diagnosed as congenital hearing impairment; there were34210girls, among them,65(1.90‰) cases were diagnosed as congenital hearing impairment. The chi-square test shows:P>0.05.3. There were6368Han nationality newborns,123cases were diagnosed as congenital hearing impairment. Among4562Hui nationality newborns, the children with congenital hearing impairment were8cases; Out of1531Dongxiang nationality newborns,2cases were diagnosed as congenital hearing impairment;1569Tibetan newborns accepted screening and5cases were diagnosed. Among121Yugur, etc newborns without hearing impairment children found. In all nationalities, the chi-square test results of incidence of congenital hearing impairment as follows: X2=0.496; P=0.060.4. There were23432newborns in east area of Gansu province,47(2.16%o) cases were diagnosed as congenital hearing impairment. There were21900newborns in intermediate area of Gansu province, among them,33(1.51‰) cases were diagnosed as congenital hearing impairment. Among15472newborns in west area of Gansu province, the children with congenital hearing impairment were39(2.52‰) cases. Out of7409newborns in Linxia area of Gansu province,14(1.89‰)cases were diagnosed as congenital hearing impairment, and in Gannan area of Gansu province, there were3254newborns, out of whom,5cases were diagnosed as congenital hearing impairment, the chi-square test results of incidence of congenital hearing impairment as follows:P>0.05.5. Among4895newborns with high-risk,29babies were diagnosed as congenital hearing impairment, including6cases with outer ear deformity and ear atresia. The incidence of congenital hearing impairment was5.92%o. Newborns with high-risk compares with the normal newborns, the chi-square test results of incidence of neonatal congenital hearing impairment as follows:X2=43.484;(P<0.001).6. Cost Benefit Analysis showed that BCR=8.66, the DPOAE combined with AABR procedure obtained the more benefits than the project costs. Conclusion:1. The incidence of congenital hearing impairment was1.93‰(138out of71,467). There were no significant statistical differences in incidence of neonatal congenital hearing impairment among all nationalities; 2.The incidence rate of peoples among different genders, regions have no significant difference;3. The incidence of neonatal congenital hearing impairment in newborns with high-risk was significantly higher than the normal birth. The craniofacial deformities were the most important risk factors to cause hearing impairment.4. The DPOAE combined with AABR procedure obtains the more benefits than the project costs. This screening project completely accords with the principle of cost effectiveness.