ABSTRACT
OBJECTIVE: Evaluate the cost-benefit, cost-utility, and cost-effectiveness of cochlear implantation, comparing it to the use of hearing aids in children with profound bilateral sensorineural hearing loss. METHODS: The nonparametric propensity score matching method was used to carry out an economic and impact assessment of the cochlear implant and then perform cost-benefit, cost-utility, and cost-effectiveness analyses. Primary information was used, taken randomly from 100 patients: 62 who received cochlear implants (treatment group) and 38 belonging to the control group who used hearing aids to treat profound sensorineural hearing loss. RESULTS: An economic cost differential was found-to the advantage of the cochlear implant-of close to US$ 204,000 between the implant and the use of hearing aids over the expected life span of the patients analyzed. This amount refers to the greater expenses that hearing-aid patients will have. With this adjusted figure, the cost-benefit indicator shows that for each dollar invested to treat the cochlear-implant patient, there is a return on the investment of US$ 2.07. CONCLUSIONS: The cochlear implant produces economic benefits for the patient. It also produces health utilities since positive cost-utility (gain in decibels) and cost-effectiveness (gain in language discrimination) ratios were found.
Subject(s)
Cochlear Implants/economics , Hearing Loss, Sensorineural/economics , Hearing Loss, Sensorineural/surgery , Adolescent , Adult , Cost-Benefit Analysis , Female , Humans , Male , Middle Aged , Young AdultABSTRACT
Objective. Evaluate the cost-benefit, cost-utility, and cost-effectiveness of cochlear implantation, comparing it to the use of hearing aids in children with profound bilateral sensorineural hearing loss. Methods. The nonparametric propensity score matching method was used to carry out an economic and impact assessment of the cochlear implant and then perform cost-benefit, cost-utility, and cost-effectiveness analyses. Primary information was used, taken randomly from 100 patients: 62 who received cochlear implants (treatment group) and 38 belonging to the control group who used hearing aids to treat profound sensorineural hearing loss. Results. An economic cost differential was foundto the advantage of the cochlear implantof close to US$ 204 000 between the implant and the use of hearing aids over the expected life span of the patients analyzed. This amount refers to the greater expenses that hearing-aid patients will have. With this adjusted figure, the cost-benefitindicator shows that for each dollar invested to treat the cochlear-implant patient, there is a return on the investment of US$ 2.07. Conclusions. The cochlear implant produces economic benefits for the patient. It also produces health utilities since positive cost-utility (gain in decibels) and costeffectiveness(gain in language discrimination) ratios were found.
Objetivo. Evaluar el costo-beneficio (CB), costo-utilidad (CU) y costo-efectividad (CE) de la implantación coclear, comparándola con el uso de audífonos en niños con hipoacusia sensorineural profunda bilateral.Métodos. Se empleó la técnica no paramétrica Propensity Score Matching (PSM) para realizar la evaluación de impacto económico del implante y así llevar a cabo los análisis CB, CU yCE. Se utilizó información primaria, tomada aleatoriamente a 100 pacientes: 62 intervenidos quirúrgicamente con el implante coclear (grupo de tratamiento) y 38 pertenecientes al grupo de control o usuarios de audífono para tratar la hipoacusia sensorineural profunda.Resultados. Se halló un diferencial de costos económicos en beneficio del implante coclear cercano a US$ 204 000 entre el implante y el uso de audífonos durante la esperanza de vida de los pacientes analizados. Dicha cifra indica los mayores gastos que deben cubrir los pacientes con audífono. Con este valor descontado, el indicador costo-beneficio señala que por cada dólar invertido en el implante coclear, para tratar al paciente, el retorno de la inversión es US$ 2,07. Conclusiones. El implante coclear genera beneficios económicos para el paciente. Tambiénproduce utilidades en salud dado que se encontró una relación positiva de CU (ganancia en decibeles) y CE (ganancia en discriminación del lenguaje).