Cost categories and analysis parameters and variations A standard set of notional costs were calculated for five key cost categories: Initial setup costs: office setup, initial training, and equipment purchase (conservatively assuming a five year equipment lifespan). Equipment maintenance costs: annual supplier maintenance, local screener and co-ordinator maintenance daily, weekly, monthly and annual. – Family costs where screening is not completed in hospital: mileage and attendance costs (e.g. parking, babysitting). Direct screening costs: consumables, labour for each screen, additional labour for refer rescreens, co-ordination for refer results, management, additional costs for community screening (assuming 10% community screening rate), tracking of lost to follow-up or referred infants, screener training and competency assessment, additional hearing assessment and therapy for infants not diagnosed with ANSD in the context of a regime using AOAE as the first screen. Diagnostic costs: assessment of false positives (two appointments), assessment of permanent bilateral moderate or greater hearing loss, and other hearing losses (four appointments), data entry and report writing. Data management were not included in the screening estimates due the difficulty of establishing a realistic average cost given the wide variety of data management processes used The parameters for the analysis of notional annual costs are set out below. Annual costs for each regime were based on: full capture of 1,000 eligible well-baby births, use of the same: screening workforce; A-ABR first, second and/or third refer rates; AOAE first, second and/or third refer rates; lost to follow-up rate; and outpatient screening rates, use of consumables, current costs expressed in (NZ$), additional time being allocated to A-ABR screening (30 minutes) compared to AOAE (20 minutes), and
Cost categories and analysis parameters and variations A standard set of notional costs were calculated for five key cost categories: Initial setup costs: office setup, initial training, and equipment purchase (conservatively assuming a five year equipment lifespan). Equipment maintenance costs: annual supplier maintenance, local screener and co-ordinator maintenance – daily, weekly, monthly and annual. Family costs where screening is not completed in hospital: mileage and attendance costs (e.g. parking, babysitting). Direct screening costs: consumables, labour for each screen, additional labour for refer rescreens, co-ordination for refer results, management, additional costs for community screening (assuming 10% community screening rate), tracking of lost to follow-up or referred infants, screener training and competency assessment, additional hearing assessment and therapy for infants not diagnosed with ANSD in the context of a regime using AOAE as the first screen. Diagnostic costs: assessment of false positives (two appointments), assessment of permanent bilateral moderate or greater hearing loss, and other hearing losses (four appointments), data entry and report writing. Data management were not included in the screening estimates due the difficulty of establishing a realistic average cost given the wide variety of data management processes used The parameters for the analysis of notional annual costs are set out below. Annual costs for each regime were based on: full capture of 1,000 eligible well-baby births, use of the same: screening workforce; A-ABR first, second and/or third refer rates; AOAE first, second and/or third refer rates; lost to follow-up rate; and outpatient screening rates, use of consumables, current costs expressed in (NZ$), additional time being allocated to A-ABR screening (30 minutes) compared to AOAE (20 minutes), and
unhseip_review_of_regime_and_devices_final_v2_july_2014.docx