Cost analysis of a school-screening program

Objective

To appraise the cost of running a school screening program in a general hospital.

Study design

A financial analysis was conducted for the estimation of the cost of our school-screening program, taking into consideration all the relevant factors, which may affect it. During the period of 1-1-2000 to 14-5-2006, 6470 pupils aged 6–18 years old were screened at schools for spinal deformities. The examiners were properly trained Health Visitors and occasionally Orthopaedic and General Medicine residents and Physiotherapists. The number of examiners who were involved in the program and their working hours, their salary on hourly basis, the expenditures required for transfer of the team and the average cost of the program for each child was calculated.

Results

During the examined period 20 examiners were involved in the program. The total number of working hours was 602. The salary per hour for the trainee doctors was 6.80€, for the Health Visitors 6.70€ and for the Physiotherapists 5.50€ in current prices. The examiners' transportation expenditures were calculated to be 32€ per year. The average cost for the examination of each child for the above studied period was calculated to be 2.24€.

Conclusion

The cost of our school-screening program is low. The present study provides a strong cost-effectiveness evidence for the continuation of the program when looking from a financial point of view. An instrumented spinal fusion for right thoracic deformity costs 1.500 – 1.700€ per level. Therefore one operation can approximately cover the total cost of our program, up to now. School screening can provide the researcher with valuable information about trunk asymmetries and epidemiological data of idiopathic scoliosis, which may contribute in further understanding of spinal deformities, at a low cost.