Cost effectiveness of screening children in health centers

Aides from poor neighborhoods in Denver, Colo., screened children in four health centers for problems in hearing, vision, articulation, and development, and children with abnormal test results were referred to specialists for evaluation. In 3 months, paraprofessional aides did 3,183 tests, of which 302 yielded abnormal results. In 146 instances, these abnormal results led to the evaluation of the children by a specialist, who recommended treatment in 95 instances. The total annual cost of maintaining one paraprofessional aide was $10,937. The average cost per test performed by such an aide was $2.87, $30 per abnormal test result, and $96 per test resulting in a decision to treat. The results show the importance of considering the later stages of followup in evaluating a screening program.