# Impact of the Improved Publicly-funded Newborn Hearing Screening Program

## TL;DR

A publicly-funded newborn hearing screening program improved detection rates and reduced delays in diagnosis and intervention for hearing loss in infants.

## Contribution

Demonstrates that public funding of newborn hearing screening improves detection and reduces diagnostic and intervention delays.

## Key findings

- Public funding detected more infants with hearing loss (51 vs. 32) compared to guardian-paid screening.
- The time to diagnostic testing decreased from 58 to 35 days with public funding.
- Intervention initiation time was reduced from 147 to 99 days under the new program.

## Abstract

To increase the coverage rate and effectiveness, universal newborn hearing screening (NHS) should be financed by public funding rather than individuals. This study investigated the impact of the publicly-funded NHS program on the detection rate and the time to diagnosis and initiation of intervention for children with congenital hearing loss.

We compared two groups: one group included newborns born between April 2011 and March 2016 who either did not pass NHS or were referred due to high risk (Group 1); the other group included newborns born between April 2017 and March 2022 who met the same criteria (Group 2). The screening costs of Group 1 were covered by the guardians’ payments, whereas those of Group 2 were covered by public funding. The NHS program in Group 2 exhibited improved screening methods, course, and timing of diagnostic hearing tests for referred newborns. The number of detected newborns with hearing impairment, the period between birth and the initial visit to a diagnostic institution, and the time to intervention were evaluated.

Group 2 had more newborns with hearing loss (n = 51) than Group 1 (n = 32), representing a significant difference (p = 0.005). Group 2 had more children with bilateral hearing loss (n = 29) than Group 1 (n = 21), but the difference was not significant. The duration until the diagnostic test was significantly reduced in Group 2 (58 days in Group 1 vs. 35 days in Group 2). The duration of intervention also was significantly reduced in Group 2 (147 days vs. 99 days).

The improved program based on public funding achieved an increased number of detected infants with hearing loss. Additionally, it shortened the durations until the first diagnostic test to an institution and intervention. The new NHS program funded by local governments achieved improved effectiveness by unifying the screening method, the course of diagnostic hearing examination, and the follow-up.