CC BY 4.0 · Int Arch Otorhinolaryngol
DOI: 10.1055/s-0043-1776703
Systematic Review

Cost-effectiveness of Neonatal Hearing Screening Programs: Systematic Review

1   Department of Postgraduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
2   Department of Speech Therapy, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
3   Department of Economics and International Relations, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
4   Department of Speech Therapy, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
5   Psychology Department, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
› Author Affiliations
Source of Funding The authors received no financial support for the present research.


Introduction Universal newborn hearing screening (UNHS) has been widely and strongly advocated as an early detection strategy for hearing loss in children. This intervention aims to prevent delays in speech and language development, which, in turn, has long-term beneficial effects on the social and emotional development and quality of life of individuals. However, the implementation of UNHS programs is circumstantial in different settings, for different reasons.

Objectives The present systematic review aimed to identify whether the implementation of UNHS programs are cost-effective, as well as their variations by localities.

Data Synthesis A search was conducted in seven databases: PubMed (Medline), Scopus, Web of Science, Embase, CINAHL, Lilacs, and Cochrane Library. Studies that included a cost analysis of UNHS programs were eligible for inclusion. Studies on evaluations of preschool or school-based programs only were excluded, among others. A total of 1,291 records were found. Of these, 23 articles were analyzed in full. All articles identified the cost-effectiveness of the UNHS programs implemented. Regarding the UNHS protocols, a wide variation was observed in all aspects: tests used, period established between tests and retests, professionals responsible for screening, environment, and criteria for defining hearing loss, limiting the generalization of this information. All studies presented values related to the expenses with the program, but none of them showed statistical elements for the described analyzes or any theoretical basis for such.

Conclusion It is necessary to estimate local specific issues, as well as the accuracy of the chosen tests and the NHS protocols used, so that more accurate analyzes on cost-effectiveness are possible.

Contributions of the Authors

Vernier L. S.: launch of the project, search algorithm, data extraction, data analysis, writing and manuscript editing; Fernandes C. P.: search algorithm, data extraction, data analysis; Skorin P. P.: data extraction, data analysis; Ávila A. T. V.: data extraction, data analysis; Levandowski D. C.: launch of the project, data analysis, critical editing of the manuscript for intellectual content.



Supplementary Material

Publication History

Received: 10 March 2023

Accepted: 15 August 2023

Article published online:
09 April 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (

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