1. THE USE OF PRAMS TO ASSESS NEWBORN HEARING SCREENING, OREGON, 2000 Kenneth D. Rosenberg, MD, MPH Alfredo P. Sandoval, MS, MBA Tina Kent Department of Human Services Office of Family Health Portland, Oregon Seventh Annual MCH Epidemiology Conference December 12, 2001 Clearwater Beach, Florida

2. Background Universal Newborn Hearing Screening (UNHS) Oregon law mandating UNHS for all babies born in hospitals with more than 200 live births per year: July 1, 2000.

3. Methods PRAMS: Pregnancy Risk Assessment Monitoring System Began asking about NHS: May 2000 Question in mailed surveys: “In the hospital or birthing center, after your baby was born, did your baby get a hearing screening?” Unweighted data

4. Results Law

5. Discussion-1 Roster Method derived from Karl White of Utah State University Oregon roster, autumn 1999: –12 hospitals with universal NHS –2 more hospitals did NHS on NICU babies –Sum = 37% of newborns getting NHS 3/00 PRAMS (baseline): over 60%

6. Discussion-2 Biases 1. Weighted sampling; unweighted analysis 2. Mothers who did not know whether their babies were tested 3. Recall bias Trend over time is robust

7. Discussion-3 Law mandating UNHS by hospitals increases NHS. NHS increased in the month before the law took effect. Almost all newborns were getting NHS after the law took effect. UNHS: standard of practice in Oregon.

8. Conclusions PRAMS: infrastructure permits flexibility MCHB Title V Performance Measure on Newborn Hearing Screening