Epidemiology of permanent hearing impairment in children in relation to costs of a hearing health surveillance program.

The objective of this investigation was to estimate the prevalence of any permanent hearing impairment (PHI) in the right and or left ear based on children included into a surveillance program in the local pediatric hearing health services (PHHS), and to analyze the costs, generated by the children. The study is a cross-sectional study, which is part of a major prospective study directed towards delineation of all aspects of pediatric audiology. The present sample comprises 228 children, 115 males and 113 females, at a median age of 13 years, range 0-24, and involves all children living in the health district of the City of Copenhagen, who are or have been included in a local surveillance program with one (school children) or two (pre-school children) annual visits for children with PHI > 20 dB HL at any frequency in either the left or the right ear. The prevalence of PHI increases with increasing age, reaching its peak in the age band 10-14 years exhibiting a rate of 5.32 1000 (95% confidence intervals: 4.27 to 6.64 per 1000). The estimated incidence of PHI in a ten year cohort born 1977-1986 is 325 100 000 children born (95% confidence intervals: 277 to 382 per 100 000). The most frequent factor causing PHI is inheritance, showing an increase from 20% in 1977-1981 cohorts, to 37% in 1982-1986 cohorts. The costs involved in the PHHS concerning PHI varies considerably from approximately 345 000 to 990 000 DKr.. depending on the model used for the economical analysis. No data on cost-benefit or cost-effectiveness can be given in this context, and it is concluded that the documented changes in the prevalence and causes of PHI in children emphasize the need for a continuous monitoring and evaluation of the epidemiological figures.