Cost-effectiveness of ultrasonographic screening for congenital hip dysplasia in new-borns

Screening for congenital dysplasia of the hips (CDH) of new-borns, mostly by Ortolani's of Barlow's tests, is widely performed, but nevertheless dysplasias are still discovered late. Ultrasonographic screening has been reported to reduce the number of these cases. The present investigation is intended to evaluate the cost-effectiveness of such as screening programme. The cost of performing ultrasound investigations at Haukeland Hospital and the treatment costs of late-discovered CDH were calculated on the basis of 26 cases of late-discovered CDH at Hagavik Orthopaedic Hospital. Figures for sensitivity and specificity were taken from the literature. General ultrasonographic screening programmes for CDH will not be cost-effective because the population screened will be too large and the demands upon sensitivity too high. However, investigating babies at risk is probably cost-effective. A CDH screening programme requires high sensitivity and one should preferably aim at screening babies at risk. In Norway a centralisation to larger hospitals may therefore be necessary.