Cost and outcome of a community-based paediatric hearing screening programme in rural India with application of tele-audiology for follow-up diagnostic hearing assessment. (3rd June 2018)

• Record Type: Journal Article
• Authors: Ramkumar, Vidya; John, K. R.; Selvakumar, K.; Vanaja, C. S.; Nagarajan, Roopa; Hall, James W.
• Is Part Of: International journal of audiology. Volume 57:Number 6(2018)
• Page Start: 407
• Page End: 414
• Publication Date: 2018-06-03
• Subjects: Community-based -- hearing screening -- paediatric -- telemedicine -- tele-audiology -- auditory brainstem response -- DPOAE screening -- grass roots workers -- rural -- economic analysis -- cost-outcomes; Audiology -- Periodicals; Hearing disorders -- Periodicals; Deafness -- Prevention -- Periodicals; Hearing Disorders -- Periodicals; Hearing -- Periodicals; 617.8
• DOI: 10.1080/14992027.2018.1442592
• Languages: English
• ISSNs: 1499-2027

Abstract

Abstract: Objective : This study evaluated the cost and outcome of a community-based hearing screening programme in which village health workers (VHWs) screened children in their homes using a two-step DPOAE screening protocol. Children referred in a second screening underwent tele diagnostic ABR testing in a mobile tele-van using satellite connectivity or at local centre using broadband internet at the rural location. Design : Economic analysis was carried out to estimate cost incurred and outcome achieved for hearing screening, follow-up diagnostic assessment and identification of hearing loss. Two-way sensitivity analysis determined the most beneficial cost-outcome. Study sample : 1335 children under 5 years of age underwent screening by VHWs. Results : Nineteen of the 22 children referred completed the tele diagnostic evaluation. Five children were identified with hearing loss. The cost-outcomes were better when using broadband internet for tele-diagnostics. The use of least expensive human resources and equipment yielded the lowest cost per child screened (Rs.1526; $23; €21). When follow-up expenses were thus maximised, the cost per child was reduced considerably for diagnostic hearing assessment (Rs.102, 065; $1532; €1368) and for the cost per child identified (Rs.388, 237; $5826; €5204). Conclusion : Settings with constrained resources can benefit from a community-based programme integrated with tele diagnostics.