The economic costs of congenital bilateral permanent childhood hearing impairment

OBJECTIVE. The objective of this study was to estimate the economic costs of bilateral permanent childhood hearing impairment (PCHI) in the preceding year of life for children aged 7 to 9 years. METHODS. A cost analysis was conducted by using a birth cohort of children born between 1992 and 1997 in 8 districts of Southern England, of which half had been born into populations exposed to universal newborn screening (UNS). Unit costs were applied to estimates of health, social, and broader resource use made by 120 hearing-impaired children and 63 children in a normally hearing comparison group. Associations between societal costs per child and severity of hearing impairment, language ability score, exposure to UNS, and age of confirmation were analyzed, including adjustment for potential confounders in a linear regression model. RESULTS. The mean societal cost in the preceding year of life at 7 to 9 years of age was pound 14 092.5 for children with PCHI, compared with pound 4206.8 for the normally hearing children, a cost difference of pound 9885.7. After adjusting for severity and other potential confounders in a linear regression model, mean societal costs among children with PCHI were reduced by pound 2553 for each unit increase in the z score for receptive language. Using similar regression models, exposure to a program of UNS was associated with a smaller cost reduction of pound 2213.2, whereas costs were similar between children whose PCHI was confirmed at < 9 or > 9 months. CONCLUSIONS. The study provides rigorous evidence of the annual health, social, and broader societal cost of bilateral PCHI in the preceding year of life at 7 to 9 years of age and shows that it is related to its severity and has an inverse relationship with language abilities after adjustment for severity.