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.

<italic>Objective</italic>: 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...

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Publicado en:International Journal of Audiology Vol. 57; no. 6; pp. 407 - 415
Autores principales: Ramkumar, Vidya, John, K. R., Selvakumar, K., Vanaja, C. S., Nagarajan, Roopa, Hall, James W.
Formato: research tables/charts Journal Article
Publicado: Taylor & Francis Ltd Jun2018
Acceso en línea:Ver este registro en EBSCOhost
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        14992027
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      dt: Jun2018
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      pub: Taylor & Francis Ltd
      place: Philadelphia, Pennsylvania
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        10.1080/14992027.2018.1442592
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        atl: 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.
      aug:
        au:
          Ramkumar, Vidya
          John, K. R.
          Selvakumar, K.
          Vanaja, C. S.
          Nagarajan, Roopa
          Hall, James W.
        affil: Department of Speech, Language and Hearing Sciences, Sri Ramachandra University, Chennai, India
      sug:
        subj:
          Health Care Costs
          Hearing Screening
          Community Health Services
          Telehealth
          Audiology
          Outcomes (Health Care)
          Human
          India
          Rural Areas
          Internet
          Evoked Potentials, Auditory, Brainstem
          Confidence Intervals
      ab: <italic>Objective</italic>: 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. <italic>Design</italic>: 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. <italic>Study sample</italic>: 1335 children under 5 years of age underwent screening by VHWs. <italic>Results</italic>: 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). <italic>Conclusion</italic>: Settings with constrained resources can benefit from a community-based programme integrated with tele diagnostics.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
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      ougenre: Article
    language: English
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