Effectiveness of the National Health Screening Program for Infants and Children in Detecting Neurodevelopmental Disorders: A Nationwide Population-Based Analysis

Abstract

Objective: To evaluate the effectiveness of the National Health Screening Program for Infants and Children (NHSPIC) in the early diagnosis of neurodevelopmental disorders (NDDs) utilizing data from the National Health Insurance Database of South Korea. Methods: We enrolled children born between 2011 and 2018 who completed the first to fourth stages of the NHSPIC. A positive finding was defined as a recommendation for further evaluation during one or more stages. Participants were categorized into the positive and negative finding groups. Following 1:1 propensity score matching, 82,138 participants were assigned to each group. Results: Comparative analysis revealed that participants with positive findings exhibited a higher risk of developing all seven NDDs, particularly for autism spectrum disorder (hazard ratio [HR], 19.70; 95% confidence interval [CI], 17.48-22.20), intellectual disability (HR, 17.11; 95% CI, 14.69-19.93), developmental language disorder (HR, 11.74; 95% CI, 10.73-12.84), and cerebral palsy (HR, 11.34; 95% CI, 8.67-14.84). The HR for learning disability was 4.31 (95% CI, 2.94-6.34), whereas attention-deficit hyperactivity disorder had an HR of 3.57 (95% CI, 3.37-3.78). Tic disorder had the lowest HR (HR, 1.64; 95% CI, 1.48-1.82). Additionally, HRs were calculated for each NHSPIC stage, demonstrating the utility of specific stages in the early detection of each NDD. Conclusion: Developmental screening tests in the NHSPIC contributed to the early diagnosis of NDDs. This study underscores the significance of the NHSPIC and provides foundational evidence to inform and enhance policies related to child health screenings.