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Expanding Access: Cost-effectiveness of Cochlear Implantation and Deaf Education in Asia.
- Source :
-
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2019 Oct; Vol. 161 (4), pp. 672-682. Date of Electronic Publication: 2019 Jun 18. - Publication Year :
- 2019
-
Abstract
- Objective: To determine the cost-effectiveness of cochlear implantation (CI) with mainstream education and deaf education with sign language for treatment of children with profound sensorineural hearing loss in low- and lower-middle income countries in Asia.<br />Study Design: Cost-effectiveness analysis.<br />Setting: Bangladesh, Cambodia, India, Indonesia, Nepal, Pakistan, Philippines, and Sri Lanka participated in the study.<br />Subjects and Methods: Costs were obtained from experts in each country with known costs and published data, with estimation when necessary. A disability-adjusted life-years model was applied with 3% discounting and 10-year length of analysis. A sensitivity analysis was performed to evaluate the effect of device cost, professional salaries, annual number of implants, and probability of device failure. Cost-effectiveness was determined with the World Health Organization standard of cost-effectiveness ratio per gross domestic product (CER/GDP) per capita <3.<br />Results: Deaf education was cost-effective in all countries except Nepal (CER/GDP, 3.59). CI was cost-effective in all countries except Nepal (CER/GDP, 6.38) and Pakistan (CER/GDP, 3.14)-the latter of which reached borderline cost-effectiveness in the sensitivity analysis (minimum, maximum: 2.94, 3.39).<br />Conclusion: Deaf education and CI are largely cost-effective in participating Asian countries. Variation in CI maintenance and education-related costs may contribute to the range of cost-effectiveness ratios observed in this study.
- Subjects :
- Asia
Cochlear Implants economics
Cost-Benefit Analysis
Developing Countries
Hearing Loss, Sensorineural economics
Humans
Cochlear Implantation economics
Correction of Hearing Impairment economics
Education economics
Health Care Costs statistics & numerical data
Health Services Accessibility economics
Hearing Loss, Sensorineural rehabilitation
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6817
- Volume :
- 161
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 31210566
- Full Text :
- https://doi.org/10.1177/0194599819849917