THE COSTS OF EARLY HEARING SCREENING IN ENGLAND AND WALES

A survey was carried out in 10 centres in England and Wales to determi ne the costs of hearing screening in the first Sear of life. The scree ns that were studied were targeted neonatal, universal neonatal, and t he health visitor distraction test (HVDT) or alternative surveillance. Valid data were available from five centres for targeted neonatal scr eening (TNS), three for universal neonatal screening (UNS), and nine f or the HVDT, although only five of the HVDT screens had valid data for follow up costs. The neonatal costs were consistent across the centre s surveyed, whereas those for the HVDT screen varied considerably. The mean service costs for TNS, UNS, and the HVDT at 1994 prices were pou nd 5052, pound 13 881, and pound 24 519 for a standardised district of 1000 live births. Three conclusions seem justified. Firstly, UNS need not be prohibitively expensive as it costs considerably less than HVD T screening. Secondly TNS appears to be a relatively inexpensive way o f improving the age of identification of a proportion of the congenita lly hearing impaired. Thirdly, given the published yields for UNS and the HVDT, the results indicate that UNS offers the most cost effective overall approach with alternative systems in place to identify late o nset permanent hearing losses.