COST-EFFECTIVENESS OF ULTRASONOGRAPHIC SCREENING FOR CONGENITAL HIP-DYSPLASIA IN NEWBORNS

Objective. Screening for congenital dysplasia of the hips (CDH) of new -borns, mostly by Ortolani's or Barlow's tests, is widely performed, b ut nevertheless dysplasias are still discovered late. Ultrasonographic screening has been reported to reduce the number of these cases. The present investigation is intended to evaluate the cost-effectiveness o f such a screening programme. Materials and methods. The cost of perfo rming ultrasound investigations at Haukeland Hospital and the treatmen t costs of late-discovered CDH were calculated on the basis of 26 case s of late-discovered CDH at Hagavik Orthopaedic Hospital. Figures for sensitivity and specificity were taken from the literature. Results. G eneral ultrasonographic screening programmes for CDH will not be cost- effective because the population screened will be too large and the de mands upon sensitivity too high. However, investigating babies at risk is probably cost-effective. Conclusion. A CDH screening programme req uires high sensitivity and one should preferably aim at screening babi es at risk. In Norway a centralisation to larger hospitals may therefo re be necessary.