South-Korea
South Korea
- Percent of children screened for hearing loss:
- Incidence of permanent hearing loss among newborns:
Current Status of Early Hearing Detection and Intervention for Children (500 word limit)
The population of the Republic of Korea is around 48 million, with about 480 000 births each year. Most women prefer to deliver their baby at a private clinic rather than a large hospital. As result, approximately 82% of babies are born at private clinics and 18% at larger hospitals. However, there are more than a thousand private OB-GYN clinics, and 37% of them have less than 100 births per year. In these locations, newborn hearing screening is not considered to be cost-efficient.
Newborn hearing screening began in the Republic of Korea in the mid-1990s when a number of private OB-GYN clinics began to follow the suggestions made by companies who imported and distributed the required devices. However, there were no guidance or quality-control systems put in place.
Meanwhile, the Association of Audiology and Otolaryngology introduced newborn hearing screening to large hospitals with most programmes initiated by ENT specialists or audiologists. Annual workshops and meetings provided education, and a series of papers reported on the data from various centres. However, there was no plan for a nationwide programme until 2004.
In order to launch a nationwide programme, a stepwise approach was used. First, the incidence of newborn hearing loss was investigated using a national survey. The incidence of bilateral hearing loss over 40dB was found to be about 0.3% with an incidence of 0.05% for hearing loss over 90dB (n = 44 066). Although the results were lower than expected, newborn hearing screening programmes had only been implemented for a short time and follow-up and data tracking were not satisfactory. Data-collection efforts are now ongoing and more accurate figures are expected to become available.
The referral rate from private OB-GYN clinics was found to be much lower than that of large hospitals. This significantly lower referral rate (0.36%) raised questions about the quality of newborn hearing screening programmes at OB-GYN clinics. An additional study found several cases of false negatives among the babies who had been classified as “PASS” by an AABR test. This clearly demonstrated a lack of education and quality control in the programmes of some OB-GYN clinics.
Since 2007, a top-down controlled programme has been tested in selected prefectures. Every year the results were analysed and the pilot-test area gradually expanded. Small private clinics without appropriate screening equipment were not allowed to be part of this programme. Tracking of the referred cases was found to be problematic.
Beginning in 2009, a coupon system was used to solve this problem. The free coupon consists of two parts (screening test and confirming test with the same ID number) and is issued to pregnant women at the public health centre. Babies born at a small clinic can be taken to any big hospital within 30 days for a screening test. Referred babies from any clinic can also be taken to any listed hospital where a confirming test is available within 90 days. Collected coupons from each institute were sent to the Ministry of Health for reimbursement. By analyzing the coupons, the tracking of babies should now be possible. The effectiveness of this system is yet to be determined.
The biggest challenges at the current time are educating participants and ensuring the application of quality-control measures in individual programmes, especially private clinics. Regular coursework with certificates is being developed. It is intended that pilot testing will be completed by 2010, and a nationwide mandatory programme launched by 2011.
Demographics
- Population (2012 est): 48,860,500
- Percent of Annual Births (2012 est): 411,400
- Birth rate: 8.42 per 1,000
- Percent of GDP spent on health care (2009): 6.5%
- Percent of Health Care expenditures spent by government: 53.9%
- Physician density: 1.967 per 1,000
- Percent of newborns attended by skilled providers: 97%
- Infant Mortality: 4.08 per 1,000
- Literacy (age 15 and over can read and write): 97.9%
Publications about EHDI Programs in South Korea (maximum of 5)
- World Health Organization. 2010. Newborn and infant hearing screening- current issues and guiding principles for action. WHO Report 2010:1-39.
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