Spine. 2000 Sep; 25(18): 2387-91.

The estimated cost of school scoliosis screening.

Yawn BP, Yawn RA.

Department of Research, Olmsted Medical Center, Rochester, Minnesota 55904, USA.

STUDY DESIGN: This is a population-based, longitudinal retrospective study of one community's school-based scoliosis screening program. OBJECTIVE: To report the estimated costs of mass school-based screening for scoliosis. SUMMARY OF BACKGROUND DATA: School scoliosis screening has been reported to cost from as little as $0. 06 to as much as $194 per child. The lower estimate considered only the cost to the school, and the higher estimate defined all children with curves of 5 degrees or more as cases. METHODS: School scoliosis screening results were linked with the medical and chiropractic care records of all referred children to identify outcomes and scoliosis-related health service utilization from Grade 5 through graduation or age 19 years. Costs are presented per child screened, per child with a spinal curve of 20 degrees or more, and per child treated for scoliosis and are based on scoliosis-related health care utilization and school costs. RESULTS: Ninety-two (4.1%) of 2197 children screened were referred for further evaluation of possible scoliosis, and 68 (74%) of those had documented evaluation for possible scoliosis. Five of the 92 children referred were treated for scoliosis by age 19. Sixty-six scoliosis-related primary care visits, 79 scoliosis-related orthopedist visits, and 79 full spine radiographs followed referral but preceded treatment. Case-finding costs for screening were $24.66 per child screened (n = 2197), $3, 386.25 per child with a curve of 20 degrees or more (n = 16) and $10, 836.00 per child treated for scoliosis (n = 5). CONCLUSION: School scoliosis screening is significantly more costly than has previously been reported.