![Sample our Health and Social Care journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5938/TOC-Subject-Sample-2021-Health-Social-Care.jpg"})
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.
Acknowledgements
We are grateful to GSI of Diagnostic Group LLC (Eden Prairie, Minnesota, USA) for providing the required equipment, accessories and support for repairs. We also thank Dr P. Balasubramanian, Executive Director, RUWSEC, for his support in the community throughout this study.
Declaration of interest
No potential conflict of interest was reported by the authors.
This study was funded (in-part) by the Indian Council of Medical Research, New Delhi, India.
Supplementary material available online
Notes
1. The word ‘infant’ refers to children under 2 years of age and “young children” refers to children between 2 and 5 years of age.
2. The term village health worker is used to refer to salaried women from the rural community with prior training in nutrition, women’s health and social welfare who received specialised training in hearing screening for this project.
3. The word “refer” in this manuscript indicates that the child did not pass the hearing screening and required referral to the next level of the screening program, either a second screening or diagnostic testing.