One of the most frequently asked questions by people who are considering the implementation of a universal newborn hearing screening program is what it will cost. Although reports from the published literature can be helpful, they are often misleading because cost analyses are done in such different ways, based on different assumptions, done by people who have a particular agenda to promote, or based on situations which may be unique to that hospital (e.g., how much the particular person doing the screening is paid, how much is charged for hospital overhead, where babies are screened, etc.). The best way to estimate the costs for a newborn hearing screening program in your hospital is to be able to specify the assumptions which are most applicable in your situation. To assist people in doing that, NCHAM has developed an accounting spreadsheet where you can specify in a few minutes all of the assumptions and cost specifications for your hospital, and the computer will automatically calculate the cost per baby, the annual total cost, and the cost per baby identified. You can also use this spreadsheet to see how the costs are affected if you set your program up in a different way--for example, if you used volunteers instead of paid hospital staff to do the screening, or if you used equipment X instead of equipment Y, or if you used a one-stage screening protocol instead of a two-stage screening protocol. The results of such variations are sometimes different than you might predict.

For the example in Table 1, we have estimated costs of a newborn hearing screening program for four of the most widely used types of screening equipment (Bio-logic AuDX, Natus Algo, Otodynamics ILO88, SonaMed Clarity). Costs for individual items are explicitly shown in the assumptions and were estimated using published literature and reports from operational programs using each type of equipment. Of course, the cost in your hospital may be different, so these are only examples. You can examine the various assumptions and make adjustments wherever they don't fit and see what happens to the costs. If you have the Microsoft Excel spreadsheet program, you can download the spreadsheet and make these changes yourself. If you don't have Excel, call us (435.797.3584) or e-mail us (ncham.helpdesk@usu.edu) and tell us what parameters you would like to change, and we will insert your assumptions and send you the results. You can also download a blank spreadsheet in which you specify all of the assumptions, and the calculations are done for you.