B4 School Screening in the Southern Region: Who Fails and What Fails?
Authors List
Oliver, T., Southern DHB, Dunedin, New Zealand
Joice, P., Southern DHB, Dunedin, New Zealand
Dawes, P., Southern DHB, Dunedin, New Zealand
Introduction: B4School hearing screening is offered to all four year old children and enables detection of ear disease. There is risk that children will not present for testing, or not progress through the subsequent referral pathways, thereby not receiving appropriate treatment.
Aim: To review the outcomes of the B4School screening programme in the Southern region with the specific aim of assessing risk factors for poor outcomes, potential inequity of care and identifying any unmet need within the system.
Methods: Records of children who underwent B4School hearing screening in 2018 were examined. Southern DHB databases were cross-referenced to determine demographics, appropriate onward referrals, and whether appropriate follow-up occurred.
Results: Of 3406 children, 17% identified as Maori, 3.5% as Pacific peoples. 3262 were screened and 326 (10%) failed screening; Maori (p=<.001) and Pacific (p=<.001) were more likely to fail. Males (p=.016) were also less likely to pass, other potential risk factors assessed did not predict a fail. DHB referral was received for only 199 children who failed screening, with 180 ultimately seen at a public hospital (55% of those who failed). While Pacific peoples (p=.014) were less likely to make it through the referral process, no other factors assessed were predictive of this outcome.
Conclusions: In the Southern region, Maori and Pacific children are significantly more likely to fail B4School hearing screening. Pacific peoples are less likely to have subsequent follow-up. There was no other evidence of inequality in referral and management outcomes for other ethnic groups, nor for rural children. A large proportion of children who fail screening are not seen in the DHB system, potentially representing a significant unmet need in the program, with implications for performance in school. Simplification of the referral process from screening to tertiary service may mitigate this problem.
Oliver, T., Southern DHB, Dunedin, New Zealand
Joice, P., Southern DHB, Dunedin, New Zealand
Dawes, P., Southern DHB, Dunedin, New Zealand
Introduction: B4School hearing screening is offered to all four year old children and enables detection of ear disease. There is risk that children will not present for testing, or not progress through the subsequent referral pathways, thereby not receiving appropriate treatment.
Aim: To review the outcomes of the B4School screening programme in the Southern region with the specific aim of assessing risk factors for poor outcomes, potential inequity of care and identifying any unmet need within the system.
Methods: Records of children who underwent B4School hearing screening in 2018 were examined. Southern DHB databases were cross-referenced to determine demographics, appropriate onward referrals, and whether appropriate follow-up occurred.
Results: Of 3406 children, 17% identified as Maori, 3.5% as Pacific peoples. 3262 were screened and 326 (10%) failed screening; Maori (p=<.001) and Pacific (p=<.001) were more likely to fail. Males (p=.016) were also less likely to pass, other potential risk factors assessed did not predict a fail. DHB referral was received for only 199 children who failed screening, with 180 ultimately seen at a public hospital (55% of those who failed). While Pacific peoples (p=.014) were less likely to make it through the referral process, no other factors assessed were predictive of this outcome.
Conclusions: In the Southern region, Maori and Pacific children are significantly more likely to fail B4School hearing screening. Pacific peoples are less likely to have subsequent follow-up. There was no other evidence of inequality in referral and management outcomes for other ethnic groups, nor for rural children. A large proportion of children who fail screening are not seen in the DHB system, potentially representing a significant unmet need in the program, with implications for performance in school. Simplification of the referral process from screening to tertiary service may mitigate this problem.
